Lymphedema

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Lymphedema

Cardiovascular system

Vascular disorders

Arterial disease

Angina pectoris

Stable angina

Unstable angina

Myocardial infarction

Prinzmetal angina

Coronary steal syndrome

Peripheral artery disease

Subclavian steal syndrome

Aneurysms

Aortic dissection

Vasculitis

Behcet's disease

Kawasaki disease

Hypertension

Hypertensive emergency

Renal artery stenosis

Coarctation of the aorta

Cushing syndrome

Conn syndrome

Pheochromocytoma

Polycystic kidney disease

Hypotension

Orthostatic hypotension

Abetalipoproteinemia

Familial hypercholesterolemia

Hypertriglyceridemia

Hyperlipidemia

Chronic venous insufficiency

Thrombophlebitis

Deep vein thrombosis

Lymphedema

Lymphangioma

Shock

Vascular tumors

Human herpesvirus 8 (Kaposi sarcoma)

Angiosarcomas

Congenital heart defects

Truncus arteriosus

Transposition of the great vessels

Total anomalous pulmonary venous return

Tetralogy of Fallot

Hypoplastic left heart syndrome

Patent ductus arteriosus

Ventricular septal defect

Coarctation of the aorta

Atrial septal defect

Cardiac arrhythmias

Atrial flutter

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Premature atrial contraction

Atrioventricular nodal reentrant tachycardia (AVNRT)

Wolff-Parkinson-White syndrome

Ventricular tachycardia

Brugada syndrome

Premature ventricular contraction

Long QT syndrome and Torsade de pointes

Ventricular fibrillation

Atrioventricular block

Bundle branch block

Pulseless electrical activity

Valvular disorders

Tricuspid valve disease

Pulmonary valve disease

Mitral valve disease

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Cardiomyopathies

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Hypertrophic cardiomyopathy

Heart failure

Heart failure

Cor pulmonale

Cardiac infections

Endocarditis

Myocarditis

Rheumatic heart disease

Pericardial disorders

Pericarditis and pericardial effusion

Cardiac tamponade

Dressler syndrome

Cardiac tumors

Cardiac tumors

Cardiovascular system pathology review

Acyanotic congenital heart defects: Pathology review

Cyanotic congenital heart defects: Pathology review

Atherosclerosis and arteriosclerosis: Pathology review

Coronary artery disease: Pathology review

Peripheral artery disease: Pathology review

Valvular heart disease: Pathology review

Cardiomyopathies: Pathology review

Heart failure: Pathology review

Supraventricular arrhythmias: Pathology review

Ventricular arrhythmias: Pathology review

Heart blocks: Pathology review

Aortic dissections and aneurysms: Pathology review

Pericardial disease: Pathology review

Endocarditis: Pathology review

Hypertension: Pathology review

Shock: Pathology review

Vasculitis: Pathology review

Cardiac and vascular tumors: Pathology review

Dyslipidemias: Pathology review

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Lymphedema p. 661, 719

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Jahnavi Narayanan, MBBS

Contributors

Tanner Marshall, MS

Vincent Waldman, PhD

Lymph is the fluid circulating in the lymphatic system, and edema refers to fluid buildup in the body’s tissues; therefore, lymphedema is a buildup of lymph somewhere in the body’s tissues.Typically, this happens as a result of some obstruction in the lymphatic system.

All right, let’s back up and briefly talk about this lymph stuff. Oxygenated blood gets sent from the heart to your tissues via arteries, which get smaller and smaller until they feed the capillary beds. The capillary beds then provide nutrients to your cells and pick up waste. Now, deoxygenated blood then feeds back into larger and larger veins, and goes back to the heart. Pressure on the arterial side is a lot higher than on the venous side, so as blood comes into the capillary bed from the smaller arteries, called arterioles, the plasma — the colorless, fluid part of blood — is literally forced out into the interstitial space, or the space between cells. The majority of that fluid is reabsorbed on the venous side, but typically there’s more forced into the tissue through the arterial side than is taken out by the venous side.

Here’s where the lymphatic system comes into play. All of that excess fluid gets pulled into the afferent lymphatic capillaries, which are closed-ended vessels found throughout the body, including, scientists discovered in 2015, in the brain. These lymphatic capillaries have larger openings than the venous capillaries, which means that in addition to the interstitial fluid, they can accept larger proteins, cellular debris, and even bacteria, which get squeezed out of the arterial side, but are too large to get back into the venous capillaries. Once all of that stuff is in the lymphatic system, it’s called lymph. Also, those afferent lymphatic vessels have one-way valves that, along with smooth muscle contraction, keep the lymph moving along toward the lymph nodes, which have immune cells that once again help filter the fluid, getting rid of potential microbial threats. The fluid then leaves the lymph nodes and drains back into the systemic veins via the thoracic duct, or left thoracic duct, which empties into the left subclavian and jugular veins, and right thoracic duct, which empties into the right subclavian and internal jugular veins, to rejoin the blood once again.

Sources

  1. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  2. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  3. "Yen & Jaffe's Reproductive Endocrinology E-Book" Elsevier Health Sciences (2017)
  4. "Bates' Guide to Physical Examination and History Taking" LWW (2016)
  5. "Robbins Basic Pathology" Elsevier (2017)
  6. "Lymphedema" Journal of the American Academy of Dermatology (2017)
  7. "Lymphedema" Journal of the American Academy of Dermatology (2017)
  8. "Differential Diagnosis, Investigation, and Current Treatment of Lower Limb Lymphedema" Archives of Surgery (2003)
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