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58 Heart edema Edema in diseases of the cardiovascular system is a consequence of insufficient work of the right parts of the heart. Heart edema develops slowly, gradually, over the course of weeks or months, appears mainly in the evening, may disappear or decrease in the morning, begin with the legs and lower abdomen, in bedridden patients – from the lower back and sacrum, are located symmetrically, dense to the touch, cold, when pressed, pits remain. In severe cases, anasarca develops: edema spreads throughout the body, tissue fluid (transudate) accumulates in the cavities, hydrothorax, ascites, and hydroperecarditis develop. Other complaints of circulatory disorders: heart fainting, hoarseness, hoarse- ness and even loss of voice, dysphagia, dyspeptic disorders, cardiac cachexia, fa- tigue, headache, insomnia. The history of the disease The doctor directs the interview so that the patient describes their complaints in chronological order and, if possible, accurately indicates the beginning, develop- ment and duration of each symptom. It is necessary to get acquainted with the entire personality of the patient, strive to gain trust and achieve cooperation. It is not rec- ommended to ask questions based on a template or collect anamnesis using printed questionnaires, because stereotypical questions are given stereotypical answers. The history of life It is collected in detail according to the scheme. Special attention is paid to Smoking. General examination It is carried out according to the General scheme. Of particular importance are: overweight, skin (with severe chronic heart failure, dry skin, dry skin appears with increased diuresis). Acrocyanosis or general cyanosis is characteristic, there may be edema. Additional research methods laboratory tests – General detailed blood analysis, biochemical blood analysis – cholesterol by fractions, sugar, liver tests, sputum analysis for coughing. instrumental – measurement of blood pressure (BP), if necessary, daily moni- toring of blood PRESSURE; electrocardiography (ECG), daily monitoring of ECG, phonocardiography (FKG), ultrasound (ultrasound) of the heart (echocar- diography), Bicycle ergometry, ultrasonography of the arteries, ultrasound of the kidneys, angiography, computed tomography (CT), pulse oximetry, x‑ray examina- tion of the lungs and heart. The second stage of the nursing process is to identify the problems of the patient and their family and formulate a nursing diagnosis. Nursing diagnoses for diseases of the cardiovascular system Level I nursing diagnoses 1. The pain in the heart area; 2. Shortness of breath;