Lymphology Association of North America (LANA) Practice Exam

Which process on the blood capillary membrane leads to edema in patients with congestive heart failure?

1. Increased reabsorption with lymphatic compensation.

2. Decreased filtration with lymphatic compensation.

3. Decreased reabsorption with lymphatic decompensation.

4. Increased filtration with lymphatic decompensation.

The correct answer is: Increased filtration with lymphatic decompensation.

In congestive heart failure, the heart's ability to pump blood effectively is compromised, leading to increased pressure in the blood vessels, particularly in the veins. This elevated pressure in the capillaries causes increased filtration of fluid out of the blood vessels into the surrounding tissues. When fluid escapes into the interstitial space, it contributes to edema, or swelling, as the excess fluid accumulates. Lymphatic decompensation refers to the lymphatic system's inability to manage or return this excess fluid effectively. When the lymphatic system cannot keep pace with the increased filtration, the fluid that has leaked out of the capillaries cannot be adequately drained away. This situation results in further accumulation of fluid in the tissues, exacerbating edema. This understanding highlights why the process of increased filtration combined with lymphatic decompensation directly contributes to edema in patients suffering from congestive heart failure. In this condition, the lymphatic system becomes overwhelmed, unable to cope with the additional fluid, leading to visible swelling and complications associated with fluid retention.