Peripheral edema in CCF | PGI based MCQs

Peripheral edema in CCF is due to: 

A. Increased sympathetic tone 
B. ANP (atrial natriuretic peptide) 
C. Increased hydrostatic pressure 
D. Pulmonary hypertension
E. all of above

The Answer is. (A) Increased sympathetic tone, (C) Increased hydrostatic pressure:

* Oedema in CCF is due to :

- Activation of Renin angiotensin system

- Increased sympathetic tone via intrinsic renal mechanism

- Increased capillary hydrostatic pressure.

- Chronic hypoxia tnay cause injury to capillary wall causing increased capillary permeability.

* Atrial Natri-uretic peptides released from atria in response to volume expansion This peptides cause increased

GFR and inhibit sodium reabsorption..

— Circulating units of ANP and BNP are elevated in CCF but obviously not sufficient to prevent edema formation and they evoke compensatory response tending to reduce cardiac load (preload and after load) by vasodilatation and by enhancing sodium and water excretion

---- In oedematous state there is abnormal resistance to actions of Natriuretic peptides.