Heart failure is a possible cause of leg swelling.1–7 Heart failure is a condition where the heart muscle is unable to fill and pump blood out to the rest of the body well.6,8,9 In this condition, the heart’s activity is much slower and less efficient and often contributes to the blood being backed up when returning to the heart.3,6–8 This can cause edema (swelling) to occur.1–8,10 Edema occurs in many tissues throughout the body including the legs, feet, ankles, thighs, abdomen, lungs, and sacrum.1–3,5–7,10 In addition to edema, other symptoms of heart failure include weight gain, dyspnea (shortness of breath), wheezing, and palpitations (high heart rate).1,5–7,10
Edema that occurs in the legs with heart failure most commonly appears as bilateral leg edema.1 Leg edema can occur with right-sided heart failure, or when left-sided heart failure is severe.1,4,6 A retrospective analysis of ambulatory adults with heart failure found that leg edema that concurrently appears with other heart failure symptoms (as opposed to being the sole symptom) is more likely to be clinically significant and warrant evaluation by a medical professional.1
Edema should be monitored frequently among adults with heart failure. In addition to checking for physical signs of edema (e.g., in their legs), patients should also monitor their weight daily on a scale. Reducing sodium intake when eating can also reduce edema.
Edema is often treated by removing the excess fluid; this often involves taking non-potassium sparing diuretics.4,6 Side effects of these diuretics may occur including impaired renal function.4 Impaired renal function is correlated with a worsening prognosis. It is also possible for leg edema to redistribute itself in other parts of the body when a patient is lying down. Fluids can be redistributed to the sacrum from the legs. Therefore, in addition to checking for physical signs of edema, it is also encouraged to monitor weight loss in order to ensure improvement of edema. Reducing sodium intake when eating can also help lead to a decrease in edema.
Heart failure is a chronic condition that worsens over time. Its prevalence increases with age and among adults with heart failure risk factors.6,8,9 For example, according to The American Heart Association, individuals with previous heart issues such as heart attack, high blood pressure, and coronary artery disease are at higher risk of having heart failure.9 Treatment for heart failure involves management of the symptoms and reduction of the number of hospitalizations as there is no cure for heart failure.6
References
- Kataoka H. Clinical significance of bilateral leg edema and added value of monitoring weight gain during follow-up of patients with established heart failure. ESC Heart Fail. 2015;2(4):106-115. doi:10.1002/ehf2.12043
- Hayn D, Fruhwald F, Riedel A, Falgenhauer M, Schreier G. Leg edema quantification for heart failure patients via 3D imaging. Sensors (Basel). 2013;13(8):10584-10598. doi:10.3390/s130810584
- Kataoka H. Clinical characteristics of lower-extremity edema in stage A cardiovascular disease status defined by the ACC/AHA 2001 Chronic Heart Failure Guidelines. Clin Cardiol. 2013;36(9):555-559. doi:10.1002/clc.22159
- Gheorghiade M, Follath F, Ponikowski P, et al. Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine. Eur J Heart Fail. 2010;12(5):423-433. doi:10.1093/eurjhf/hfq045
- Leier CV, Chatterjee K. The physical examination in heart failure--Part II. Congest Heart Fail. 2007;13(2):99-104. doi:10.1111/j.1527-5299.2007.06491.x
- Inamdar AA, Inamdar AC. Heart failure: diagnosis, management and utilization. J Clin Med. 2016;5(7). doi:10.3390/jcm5070062
- American Heart Association. Warning Signs of Heart Failure. 2017. American Heart Association. https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure. Accessed April 28, 2020.
- Roger VL. Epidemiology of heart failure. Circ Res. 2013;113(6):646-659. doi:10.1161/CIRCRESAHA.113.300268
- American Heart Association. What is Heart Failure? 2017. American Heart Association. https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure. Accessed April 28, 2020.
- Leier CV, Chatterjee K. The physical examination in heart failure--Part I. Congest Heart Fail. 2007;13(1):41-47. doi:10.1111/j.1527-5299.2007.06409.x