Peripheral edema in CCP is due to-
Ref: KV Krishna Das - Clinical Medicine 4th Edition pg no:175-176 Right sided hea failure is accompanied by systemic venous congestion and peripheral edema, whereas left sided hea failure is accompanied by pulmonary venous congestion and pulmonary edema. Dependent edema, paicularly prominent towards evening is a characteristic symptom of congestive cardiac failure. The sequence of events is: rise in jugular venous pressure, enlargement and tenderness of the liver, and dependent edema. As the condition progresses, symmetric dependent edema sets in. This is preceded by weight gain of 3 to 4 kg due to water retention. Though the edema is predominantly over the dependent pas, with worsening of the condition, the edema may extend to the thighs, abdominal wall and face, paicularly in children. Ascites may also develop. Similar distribution of edema can occur in cirrhosis of liver, but in cirrhosis, ascites is more prominent than peripheral edema. In chronic right sided hea disease such as tricuspid incompetence, constrictive pericarditis and right ventricular endomyocardialfibrosis, chronic venous congestion of the liver leads to cardiac cirrhosis. In these conditions ascites tends to be more prominent than peripheral edema
Increased sympathetic tone
ANP (atrial natriuretic peptide)
Increased hydrostatic pressure
Pulmonary hypeension
C.V.S