Which feature is more characteristic of venous edema than cardiac edema?

• A. Edema dependent with skin changes.
• B. Edema symmetric with hepatomegaly.
• C. No edema.
• D. Edema circumferential with no skin changes.

Answer: (B)

The key idea is telling venous edema apart from cardiac edema by looking at where the fluid collects and what skin and organ signs accompany it. Venous edema from chronic venous insufficiency tends to pool in dependent parts, usually the legs when standing, and is often accompanied by skin changes from venous stasis—stasis dermatitis, hyperpigmentation, and sometimes lipodermatosclerosis. Cardiac edema from congestive heart failure, on the other hand, is typically symmetric and often comes with signs of congestion in the liver and other organs, such as hepatomegaly from hepatic venous congestion, along with possible ascites or pleural effusions.

So the feature that is more characteristic of venous edema is edema that is dependent and has skin changes. Edema that is symmetric with hepatomegaly points to cardiac involvement rather than venous edema. The other options don’t fit venous edema patterns as well since skin changes are a hallmark of venous stasis, not the circumferential edema without skin changes or absence of edema.