Heat Edema

Other Names

• Heat Edema

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Background

• This page refers to Heat Edema, a mild and self limited condition seen in athletes exercising in warm environments

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Pathophysiology

• General
  • Often seen in traveling athletes arriving from cooler climates
  • More common in older adults than conditioned athletes
  • Feet and ankles most frequently affected
  • Resolves spontaneously in days to weeks

Etiology

• General
  • Thought to be from vasodilation and increased hydrostatic pressure
  • Body is attempting to shunt warm blood to the periphery
  • This increases heat dissipation in the skin
  • Capillary permeability is also increased
  • Tends to occur in a dependent manner (feet and ankles)

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Risk Factors

• Demographic
  • Older adults
• Systemic
  • Cardiovascular disease
  • Diabetes Mellitus
  • Kidney Disease
  • Pregnancy
• Environmental
  • Lack of acclimatization
• Other
  • Prolonged periods of standing

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Differential Diagnosis

Differential Diagnosis of Lower Extremity Edema

• Cardiac Disease
• Liver Disease
• Kidney Disease
• Deep Vein Thrombosis
• Venous Insufficiency
• Cellulitis
• Peripheral Vascular Disease

Differential Diagnosis Heat Illness

• Minor
  • Milaria
  • Heat Edema
  • Sunburn
  • Heat Tetany
  • Heat Cramps
• Major
  • Heat Syncope
  • Heat Exhaustion
  • Exertional Heat Stroke
  • Rhabdomyolysis

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Clinical Features

• History
  • Patient will often have a recent travel to a warmer climate
  • Occurs in first few days exposure to increased temperature
  • Primarily patients report soft tissue swelling
  • There are no associated symptoms
• Physical Exam
  • Edema is typically limited to feet, ankles and hands
  • It is symmetric and pitting
  • Core temperature is normal

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Evaluation

• Clinical evaluation, no work up is required

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Classification

• Not applicable

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Management

• General
  • Elevation of legs
  • Compression stockings as needed
  • Ensure athlete is hydrated
  • Adequate salt intake
  • Move to cooler environment if possible
• Not indicated
  • Diuretics (no proven benefit, may be harmful)

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Rehab and Return to Play

Rehabilitation

• Not applicable

Return to Play/ Work

• Not applicable

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Complications and Prognosis

Prognosis

• Self limited condition with excellent prognosis
  • Condition tends to improve in 7-14 days
  • Duration can be up to 6 weeks

Complications

• None

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See Also

• Heat Related Illness Main

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