Pitting Edema and Vein Disease: What's the Connection?

Written By Center for Vein Restoration
Blog Image Pitting Edema And Vein Disease

Pitting edema is a type of swelling characterized by the presence of a dimple or "pit" that remains in the skin after pressure is applied. Usually occurring in the lower body, such as in the legs, feet, and ankles, the severity of pitting edema is assessed based on the depth and duration of the pit. Brought on by excess fluids in the body, causes of pitting edema can be benign (standing or sitting too long, or pregnancy) or a sign of more serious conditions (blood clots, congestive heart failure, or vein problems).

This blog explores the causes, symptoms, and treatment options for pitting edema, particularly focusing on its relationship with vein disease. Understanding the connection between pitting edema and vein disease is crucial for accurate diagnosis and management.

What is Pitting Edema?

Pitting edema occurs when excess fluid accumulates in the tissues, leading to swelling. If an indentation remains in the skin after pressure is applied to the swollen area, lasting for several seconds before the skin returns to its original position, it is the difference between edema and pitting edema.

What are the Symptoms of Pitting Edema?

The symptoms of pitting edema can vary depending on the underlying cause but generally include:

  • Swelling in the affected area, often in the legs, ankles, or feet
  • A dimple or "pit" that remains after pressing the swollen area
  • Stretched, shiny, or reddened skin
  • A feeling of heaviness or fullness in the affected limb
  • Difficulty moving joints due to swelling
  • Warm or hot skin in the swollen area

While these symptoms may be uncomfortable, they are not necessarily dangerous. However, individuals experiencing shortness of breath, chest pain, irregular heartbeat, or coughing should seek immediate medical attention, as these could be signs of fluid in the lungs, known as pulmonary edema, which is life-threatening.

What Causes Pitting Edema?

According to the Mayo Clinic, edema occurs when tiny blood vessels, called capillaries, leak fluid into nearby tissues, causing a buildup that results in swelling.

Causes of mild edema include:

  • Eating salty food
  • Being premenstrual or pregnant
  • Sitting or standing in a single position for too long
  • High blood pressure medications
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Steroid use

More serious causes of edema include:

  • Heart Disease: According to Yale Medicine, heart disease is often the cause of pulmonary edema. Congestive heart failure can lead to tissue fluid buildup, causing pitting edema, particularly in the legs.
  • Kidney Disease: Impaired kidney function can result in salt and water retention, leading to edema.
  • Liver Disease: Conditions like cirrhosis can disrupt normal blood flow through the liver, causing fluid to accumulate in the lower extremities.
  • Vein Problems: Chronic venous insufficiency (CVI) and deep vein thrombosis (DVT) are common venous issues that can cause pitting edema.

Remember, persistent or severe symptoms warrant medical attention, especially if accompanied by breathing difficulties or chest pain.

Vein Disease and Pitting Edema

Imagine your veins are like tiny highways carrying blood back to your heart. In the case of leg vein problems, these highways get backed up because the tiny valves inside the legs that keep fluids moving are weak or damaged. This can cause blood and fluids to pool in your legs.

Normally, your body has an efficient drainage system to eliminate this extra fluid. But when valves that transport the blood up against gravity break down, the pressure in the veins builds up. This pressure pushes fluid out into the spaces between the cells in your legs, causing them to swell up. That's what makes your legs get puffy and leaves an indent when you press on them; that's the "pitting" part of pitting edema.

There are three reasons this fluid leaks out:

1. Chronic Venous Insufficiency (CVI)
CVI occurs when the veins in the legs fail to return blood to the heart efficiently, leading to blood pooling in the lower extremities. This condition is often due to damaged or weakened vein valves. The resulting increased pressure in the veins causes fluid to leak into the surrounding tissues, leading to edema.

Learn more about edema, including how to spot it and what to do if you have it.

2. Pressure Overload
Imagine the pressure in your veins is like water inflating a balloon. Normally, the pressure is just enough to keep the balloon (vein) slightly inflated and functioning properly. However, vein problems like CVI cause extra pressure that stretches the walls of your veins outwards. Because the veins are more stretched than usual, tiny gaps or weaknesses can appear. These gaps act like little holes, allowing fluid to leak out of the veins and into the surrounding tissues in your legs. This fluid buildup is what causes the swelling and pitting you see with edema.

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    3. Deep Vein Thrombosis (DVT)
    According to MedicalNewsToday, a DVT blood clot can block blood flow, leading to swelling in the affected leg. The swelling may be significant, causing the leg to appear much larger than the other. This type of swelling is often called pitting edema because, when pressed, an indentation or "pit" remains for a short time. DVT is a serious condition that requires immediate medical attention to prevent complications such as pulmonary embolism.

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      Diagnosis of Pitting Edema

      Diagnosing pitting edema involves a thorough medical history and physical examination. Physicians will assess the timing, location, and extent of the edema, as well as any associated symptoms. Additional tests may include blood tests, urine tests, and imaging studies such as ultrasound to evaluate the underlying cause.

      Treatment for Pitting Edema

      Treating pitting edema focuses on addressing the underlying cause and managing symptoms. Common treatment options include:

      • Compression Therapy: Wearing compression stockings can help reduce swelling by improving blood flow in the veins.
      • Medications: Diuretics may be prescribed to help the body eliminate excess fluid. Other medications may be used to treat the underlying condition, such as heart or kidney disease.
      • Lifestyle Changes: Reducing salt intake, elevating the legs, and engaging in regular physical activity can help manage edema.
      • Outpatient Interventions: For individuals with chronic venous insufficiency, minimally invasive treatments such as radiofrequency or laser vein ablation or ambulatory phlebectomy may be necessary to improve blood flow and reduce edema.

      Preventing Pitting Edema

      Preventing pitting edema involves managing risk factors and underlying health conditions. Some preventive measures include:

      • Maintaining a healthy weight
      • Staying active and avoiding prolonged periods of sitting or standing
      • Wearing compression stockings if you have a history of vein problems
      • Managing chronic conditions such as heart, kidney, or liver disease
      • Reducing salt intake to prevent fluid retention

      What Should I Do If I Have Pitting Edema?

      Pitting edema is a common condition that can indicate underlying vein disease or other health issues. By addressing the underlying causes and implementing appropriate management strategies, individuals can reduce symptoms and improve their quality of life

      One of the best steps you can take is to consult a vein care specialist at Center for Vein Restoration (CVR). CVR vein doctors have the expertise to diagnose and treat vein-related issues that may be causing your pitting edema.

      Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR near you today.

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