swelling of the vocal folds of the larynx due to a build-up of fluid in Reinke’s space, between the internal fibromuscular layer of the vocal fold and its overlying mucosa. It is caused by smoking, vocal overuse, *gastro-oesophageal reflux, or thyroid disease. [F. B. Reinke (1862–1919), German anatomist]
This is a syndrome in women, characterised by irregular intermittent bouts of generalised swelling. Sometimes the ?uid retention is more pronounced before the menstrual period (see MENSTRUATION). The eyelids are pu?y and the face and ?ngers feel sti? and bloated. The breasts may feel swollen and the abdomen distended, and ankles may swell. The diurnal weight gain may exceed 4 kg. The underlying disturbance is due to increased loss of ?uid from the vascular compartment, probably from leakage of protein from the capillaries increasing the tissue osmotic pressure. Recent evidence suggests that a decrease in the urinary excretion of DOPAMINE may contribute, as this has a natriuretic action (see NATRIURESIS). This may explain why drugs that are dopamine antagonists, such as chlorpromazine, may precipitate or aggravate cyclical oedema. Conversely, bromocriptine, a dopamine agonist, may improve the oedema.... cyclical oedema
This occurs as a result of left ventricular failure (see HEART, DISEASES OF). There is an abrupt increase in the venous and capillary pressure in the pulmonary vessels, followed by ?ooding of ?uid into the interstitial spaces and alveoli. The commonest cause of acute pulmonary oedema is myocardial infarction (see HEART, DISEASES OF) which reduces the ability of the left ventricular myocardial muscle to handle the blood delivered to it. Pulmonary oedema may result from other causes of left ventricular failure such as HYPERTENSION or valvular disease of the mitral and aortic valves. The initial symptoms are cough with breathlessness and occasionally with wheezing (once called ‘cardiac asthma’). The patient becomes extremely short of breath and in a severe attack the patient is pale, sweating and cyanosed and obviously gasping for breath. Frequently, frothy sputum is produced which may be blood-stained. Treatment is with DIURETICS and measures to deal with the myocardial infarction or other underlying cause.... oedema of the lungs
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