Leg Swelling: Is It Heart-Related or Something Else?

Heart

I have been experiencing swelling and discomfort, particularly in my calves and feet, for several years, often making it difficult for me to stand for long periods.
I initially thought this was due to poor blood circulation, bad posture, or prolonged sitting at work leading to edema.
However, according to Traditional Chinese Medicine, my condition is not edema, as pressing on the muscles does not leave a deep indentation.

My blood pressure is generally within normal limits, but the systolic and diastolic pressures are sometimes very close together (about a 20-point difference).
Three years ago, my health check report indicated that my electrocardiogram was normal.
Recently, I have noticed an increase in the frequency and duration of pain and weakness in my left hand, along with occasional shortness of breath and difficulty breathing.

Since the veins in my limbs are clearly visible, a Traditional Chinese Medicine practitioner suggested that my condition may stem from a weak heart, compounded by hereditary high cholesterol, leading to varicose veins, which in turn causes my limbs to swell and ache, making it difficult to sit or stand for long periods.
Another doctor mentioned that my symptoms could be due to poor venous return in my lower limbs, heart abnormalities, or issues with my mitral valve.

I would like to ask the doctor if my condition is caused by inadequate heart function leading to varicose veins, or if it is related to mitral valve problems.
How should I proceed with seeking medical attention? Thank you for your time in addressing my concerns.

wen, 30~39 year old female. Ask Date: 2004/07/27

Dr. Zhong Yuxun reply Cardiology

Hello Wen,
The possible causes of the symptoms you described have already been mentioned by you.
It is best to consult a cardiologist for diagnosis and treatment.
Generally, cardiac dysfunction does not cause lower extremity varicose veins.
Additionally, traditional Chinese medicine often differs significantly from Western medicine, which can be verified through scientific instruments.

Dr.
Zhong Yuxun

Reply Date: 2004/07/27

More Info

Leg swelling, particularly in the calves and feet, can indeed be a complex issue that may have various underlying causes, including cardiovascular problems. Given your symptoms and medical history, it is essential to consider several factors that could contribute to your condition.

Firstly, the swelling in your legs could be related to venous insufficiency, which occurs when the veins struggle to return blood from the legs back to the heart. This can lead to fluid accumulation in the lower extremities, resulting in swelling, discomfort, and even varicose veins. Your mention of visible blood vessels and the discomfort you experience after prolonged sitting or standing aligns with this condition.
Additionally, your report of increased frequency and duration of left arm pain and weakness, along with episodes of shortness of breath, raises concerns about potential cardiac issues. While your blood pressure readings are within normal limits, the close proximity of your systolic and diastolic pressures (about a 20 mmHg difference) could indicate some underlying cardiovascular strain.
The heart's ability to pump effectively is crucial for maintaining proper circulation. If the heart is not functioning optimally, it can lead to fluid retention and swelling in the extremities. Conditions such as heart failure, where the heart cannot pump blood efficiently, can cause similar symptoms. Furthermore, issues with the mitral valve, such as mitral valve prolapse or regurgitation, could also contribute to your symptoms, as they can affect the heart's efficiency and lead to fluid buildup.

Your description of the swelling not being "pitting" (where pressing on the swollen area leaves an indentation) suggests that it may not be typical edema caused by heart failure or kidney issues. This could point towards other causes, such as lymphatic obstruction or localized venous issues.
Given your family history of high cholesterol and the symptoms you are experiencing, it is advisable to consult a cardiologist for a thorough evaluation. A comprehensive assessment may include:
1. Echocardiogram: This ultrasound of the heart can help assess the structure and function of the heart, including the mitral valve's condition.

2. Doppler Ultrasound: This test can evaluate blood flow in the veins of your legs to check for any blockages or venous insufficiency.

3. Electrocardiogram (ECG): Although you mentioned a normal ECG three years ago, a current ECG can provide insights into your heart's electrical activity and detect any abnormalities.

4. Blood Tests: These can help assess cholesterol levels, kidney function, and other markers that may indicate cardiovascular health.

In conclusion, while your symptoms could be related to venous insufficiency or other non-cardiac issues, the combination of leg swelling, arm discomfort, and shortness of breath warrants a thorough cardiac evaluation. It is essential to address these symptoms promptly to rule out any serious underlying conditions and to receive appropriate treatment. Please consult with a healthcare professional who can guide you through the necessary diagnostic steps and develop a tailored management plan based on your findings.

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