What is pitting edema of both lower extremities likely associated with?

Pitting edema in both lower extremities is commonly associated with cardiac or systemic origin due to its pathophysiological connection to fluid retention and increased hydrostatic pressure in the vascular system. When the heart is unable to pump blood effectively, as seen in conditions like heart failure, fluid can accumulate in the lower extremities. This condition leads to pitting edema, which is characterized by the indentation that remains after pressure is applied to the swollen area.

Additionally, various systemic conditions, such as kidney or liver dysfunction, can alter fluid balance and lead to similar findings. These systemic issues can also result in fluid shifts and retention, causing bilateral pitting edema. The nature of pitting edema thus reflects underlying cardiovascular or systemic factors rather than localized issues.

In contrast, other options like deep venous thrombosis typically present as unilateral swelling due to obstruction of venous return, while primary varicose veins are more associated with chronic venous insufficiency, which may cause swelling but not usually pitting edema in both legs. Lipidemia results in abnormal fat accumulation and does not typically cause the same pitting indentation effect. Hence, cardiac or systemic causes are the primary factors associated with bilateral pitting edema in the lower extremities.