Diagnosis:

Diagnosing the underlying cause is essential for treating edema effectively. When you seek treatment for unexplained edema, your physician will start by taking a medical history. The questions will focus on the timing, location, severity, and duration of your symptoms. Your physician will also ask questions to determine whether you have had any other signs or symptoms of kidney, liver, thyroid, lung, or heart disease that may help in diagnosing the underlying cause of your swelling.

Your doctor will then perform a physical examination. The examination is likely to be extensive, and will include listening to your heart and lungs, examining your skin and nails, testing your skin tone and its response to pressure, and looking at the whites of your eyes. The purpose of the exam is to determine whether you display any signs or symptoms of heart, lung, liver, or kidney disease that may be causing your edema.

Blood and urine tests will help your physician determine whether or not you have liver or kidney disease. When the kidneys are damaged, they excrete excessive amounts of protein into the urine. A urine test can detect any excess protein. Similarly, reduced blood levels of the protein albumin may indicate serious kidney disease. Blood tests can also be used to test for liver disease, heart disease, and thyroid disease that may be contributing to your edema.

Your physician may order an x-ray of your lungs to test for lung disease or congestive heart failure.. Tissue damage caused by chronic lung diseases such as COPD, emphysema, or chronic bronchitis is usually visible on a chest x-ray. In addition, the x-ray can also determine whether fluid is building up in the air sacs of your lungs, resulting in heart failure.

In cases where heart disease is a suspected cause of the edema, your physician may order cardiac tests.

• Electrocardiogram. An electrocardiogram (ECG) is a test that records the electrical impulses of the heart. It can show any type of heart rhythm disturbances.

• Echocardiogram. An echocardiogram uses sound waves that are transmitted to the heart, and is essentially the same technology used in an ultrasound to observe a fetus in a pregnant woman. The echoes are produced when the waves are reflected back and turned into images by an instrument called a transducer. An echocardiogram provides very specific information about the size of the heart's chambers, the heart's pumping function, the cardiac valve motion (which demonstrates whether they are closing and opening properly), and any changes in the blood vessels and other structures in and around the heart. One part of the echocardiogram, known as a “Doppler,” measures the speed and direction of the bloodflow, and can pinpoint narrowing of the valves (stenosis), or leakage in the valves (regurgitation).