Wednesday, April 10, 2024

Congestive Heart Failure Swollen Ankles

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Can Diabetes Cause Ankle And Leg Swelling

Edema – Fluid Retention due to Congestive Heart Failure

As mentioned above, diabetes is one of the main causes of edema and thus ankle swelling. Thats because it has many direct and indirect effects on the body that can lead to fluid retention.

As a diabetic, it is highly likely that the disease is the underlying cause or exacerbating factor of the swelling in your legs.

Congestive Heart Failure Procedures And Interventions

Other treatments or procedures may be offered, depending on the underlying cause of the heart failure.

Angioplasty: This is an alternative to coronary bypass surgery for some people whose heart failure is caused by coronary artery disease and may be compounded by heart damage or a previous heart attack. Angioplasty is performed to treat narrowing or blockage of a coronary artery that supplies the left ventricle with blood. The narrowing or blockage is caused by cholesterol deposits.

  • Angioplasty begins with the cardiac catheterization procedure during which a long, thin tube called a catheter is inserted through the skin, into a blood vessel, and threaded into the affected artery. This procedure is performed while the person is under local anesthesia.
  • At the point of the atherosclerotic narrowing or blockage, a tiny balloon and/or an expandable metal stent, attached to the end of the catheter, is inflated and/or deployed.
  • The expanded stent pushes aside the cholesterol deposits that are blocking the artery so that blood can flow through in a more normal manner.

Pacemaker: This device controls the rate of the heartbeat. A pacemaker may keep the heart from going too slow, increasing heart rate when the heart is not increasing enough with activity. It also helps sustain regular rates when the heart is not beating in a coordinated way. Or, the pacemaker performs some combination of these.

You Stand Or Sit For Hours At A Time

Counter people, doctors, nurses, and others who work on their feet often end the day feeling like their shoes are too tight. Here’s why: when you don’t move much while standing, the muscles in your legs, ankles, and feet don’t have a chance to contract, causing blood flow to and from your feet to slow down.

The same thing happens to people who sit for long stretches. Reduced blood flow triggers swollen feet, making shoes feel tight and uncomfortable. And if you’re sitting cross-legged, pinched blood vessels caused by the position you’re in can aggravate the swelling.

While annoying, this kind of end-of-the-day swelling is usually not indicative of a larger problem and should go away once you’ve walked around or uncrossed your legs. “There are no hard and fast guidelines, but if you’re on your feet all day long, it’s reasonable to sit five minutes every hour, or put your legs up,” said Jason Johanning, MD, professor of vascular surgery, University of Nebraska Medical Center, Omaha.

If the swelling persists or you can’t take breaks from standing or sitting, give compression stockings a try. “Compression stockings work the same way as walking and add a bit of pumping action to keep the blood flowing a little faster,” said Roy Silverstein, MD, president of the American Society of Hematology and chair of the department of medicine at the Medical College of Wisconsin.

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Pneumatic Compression Mechanical Device

Imagine a blood pressure cuff worn on the body that intermittently inflates, compresses, and deflates through various cycles. Thats the idea behind a pneumatic compression device.

Theyre typically sold as boots you slip into or as a large wrap that goes around your lower leg and fastens with velcro. They massage your legs, and a small study published in 2014 in Lympathic Research and Biology suggested that edema decreased or didnt get worse after using a pneumatic compression device for three years.

There have been some very small studies showing their safety in heart failure, says Dr. Horwich. But most physicians would say that more studies are needed to better clarify their use in heart failure patients. It may be worth a try, if not for edema then for achy legs. Just check with your doctor first.

Signs of Congestive Heart Failure

What Is Acute Heart Failure?

These Are the Four Stages of Heart Failure

  • Lee Goldberg, MD, a cardiologist and section chief, Advanced Heart Failure and Cardiac Transplant at the University of Pennsylvania, in Philadelphia, and a professor of cardiovascular medicine in the Perelman School of Medicine at the University of Pennsylvania
  • Columbus Batiste, MD, an interventional cardiologist at Kaiser Permanente in Riverside, California
  • Tamara Horwich, MD, associate clinical professor of medicine and cardiology at the David Geffen School of Medicine
  • Jenifer Bowman, a registered dietitian at UCHealth based in Fort Collins, Colorado

What Is Heart Failure

Congestive Heart Failure Feet Swelling

Heart failure does not mean your heart has failed. It means that your heart is not pumping blood as well as it should.

As your hearts pumping power diminishes, your organs no longer work as well. They simply arent getting the oxygen and nutrients they need.

Your kidneys, for example, are no longer eliminating water and salt efficiently. Fluid builds up in places like the feet. ankles, arms, belly, and lungs, Your body, in effect, becomes congested. The term used to describe this condition is congestive heart failure.

Its this excessive fluid retention that puts most people with heart failure in the hospital, explains Gomer.

Swollen feet may be a symptom, but its excessive fluid retention often throughout the body that puts most people with heart failure in the hospital.

While in the hospital, people are given potent diuretics for a week or two, and usually their salt and fluid intakes are restricted. As a result, the excess salt and fluid in the lungs is excreted, and people lose a lot of weight, mostly water. Swelling in the feet, ankles, and bellies subsides. Once the fluid is gone, people no longer feel as if theyre suffocating, and theyre sent home.

However, in most cases they are back in the hospital within a few months because they went back to their unhealthy, salty diets and maybe stopped their diuretics.

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Heart Failure And Edema

Edema develops when water gets trapped in your body tissues. This results in swelling, usually in your feet or ankles, but it can also affect your entire body.

As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing fluid to build up in tissues. The kidneys are less able to get rid of sodium and water in the body, which also causes fluid retention in tissues.

More Plant Protein Less Animal Protein

Researchers at the 2016 annual scientific sessions11 of the American Heart Association reported that among 100,000 post-menopausal women, those with the highest intake of plant protein had the lowest risk of heart failure. Excellent sources of plant protein are legumes and beans.

During a healthy vacation at the Pritikin Center, guests are introduced to a comprehensive lifestyle-change program consisting of a healthy diet, safe and sustainable exercise, and stress management, all supervised by board certified physicians.

Conversely, those women who ate the highest amount of animal protein, such as meat and cheese, had the highest risk of developing heart failure.

Summed up lead investigator, Mohamad Barbour, MD, of Brown University Medical School: This is more evidence that taking a pill is not as important as what we do every day in our lifestyle, not only in diet but in exercising as well.

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Symptoms Of Congestive Heart Failure

In addition to shortness of breath while resting, shortness of breath during physical exertion is a symptom of congestive heart failure. Edema in the ankles, legs or feet, and rapid or irregular heartbeat could also signal the condition. A reduced ability to exercise, persistent cough or wheezing with white or pink blood tinged phlegm are also symptoms. Other signs include the increased need to urinate at night, a swelling of the abdomen and sudden weight gain from fluid retention. Sometimes written off as a gastronomic issue, a lack of appetite or nausea could also be symptomatic of congestive heart failure. Unusual mental tendencies, such as experiencing less alertness than usual or having difficulty concentrating are also signs that congestive heart failure could be occurring.

It is very important to take sudden, severe shortness of breath and coughing up pink foamy mucus, seriously. Those issues and chest pain are also congestive heart failure symptoms.

Is This An Emergency

Heart Failure Warning Signs and Symptoms

Chronic swelling in the legs as a symptom by itself isn’t typically a medical emergency. “Call and make an appointment with your primary care physician or cardiologist,” said Dr. Bhakta. The biggest concern with vein-related leg swelling is that the signs could also be connected to pulmonary hypertension.

The first thing your primary care physician or cardiologist likely will do is perform an ultrasound examination of your leg veins and an ultrasound of your heart, or an echocardiogram, according to Dr. Bhakta.

The most often recommended non-medical treatment is compression stockings, which compress the veins and ensure that blood continues to flow.

If the exam shows that the valve in a leg vein is deteriorating to a significant degree, your doctor may recommend venous ablation. In this procedure, a medical-grade adhesive seals off the damaged vein.

If your doctor determines that your leg swelling is related to pulmonary hypertension or heart failure , you’ll probably undergo additional tests to determine the best treatment. Treatments for both pulmonary hypertension and heart failure include medications and surgery.

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Beebe Interventional Cardiologists Perform Life

Structrual heart disease in a new and up-and-coming field of cardiology where certain procedures on the heart, that required open heart surgery before, can now be performed via minimally invasive femoral artery access in an interventional cardiology lab. Beebe has a talented and enthusiastic group of very well-trained interventional cardiologists and cardiothoracic surgeons that are performing some of these procedures with great success.

If your quality of life has changed due to high blood pressure, swelling, or inflammation possibly caused by a heart condition, Beebe’s structural heart team may be able to help.

Talk to your cardiologist about your heart condition and if a procedure may improve your quality of life.

Beebe offers advanced procedures for heart conditions:

If you experience ongoing fatigue, shortness of breath, or trouble walking distances that you used to be able to accomplish – you could have aortic stenosis. Learn more.

If you have issues with blood flow through your ventricles, aorta, or mitral valve, Beebe can help. Learn more about Cardiovascular Services.

When Is Surgery Necessary For Congestive Heart Failure

Surgery can repair some underlying causes of heart failure, such as blockage of the coronary arteries, a valve problem, a congenital heart defect, or thickened pericardium. For patients with severe coronary artery disease, coronary artery bypass graft surgery can be conducted to circumvent blockages in vessels and ensure that the heart muscle maintains its blood supply. Valve replacement surgery can also be performed to repair malfunctioning heart valves. However, once the heart’s ability to pump blood is severely, permanently, and irreversibly impaired, no surgery can repair the damage. The only alternative is a heart transplant. This option is for patients who are not elderly and who do not have other medical conditions that would make it unlikely for a heart transplant to be successful. Heart transplant evaluations are done in specialized centers. Over the years there have been new innovations in the field of cardiac surgery and if a heart transplant is not available, a left ventricular assist device may be implanted to help prolong life.

Left ventricle assist device : This device is surgically implanted to mechanically bypass the left ventricle. It can be used as a âbridge to transplantâ until a heart transplant is available.

  • Alternatively, LVADs are also being used as âdestination therapyâ in patients who are not eligible for a transplant, but only at approved specialized medical centers.

Congestive Heart Failure Follow-up

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Other Causes Of Edema

Heart failure is not the only cause of swelling in the feet. Allergic reactions, burns, trauma, blood clots, or severe inflammation can cause edema as well.

Other causes can include:

  • Gravity: If youve been sitting or standing in one place for too long, gravity gradually pulls the fluid in your body down to your legs and feet.
  • Varicose veins:Veins in your legs cant get blood back up to your heart, causing blood to collect in your legs.
  • Medications: Blood pressure or pain medications can cause swelling.
  • High salt intake:You may not be aware that your sodium intake is high. Processed or packaged foods, olives, legumes, and cheese can have high amounts of sodium.
  • Pregnancy: As the baby grows, the uterus puts pressure on the blood vessels in the lower half of your body.
  • Thyroid disease: Both hypothyroidism and hyperthyroidism can cause edema.

How To Help Prevent Kidney Disease When You Have Diabetes


Kidney Disease Edema can occur because the disease leads to extra fluid and sodium in the circulatory system, which then builds up pressure in the blood vessels and leads to swelling. Kidney disease can cause edema in multiple areas.

Kidney Damage Nephrotic syndrome which occurs when the small filtering blood vessels in the kidneys dont work properly and allow protein to be lost in the urine can result. This causes a declining level of protein in the blood, which can lead to fluid accumulation and edema.

Liver Cirrhosis A scarring of the liver tissue, it can lead to abdominal edema. This happens because cirrhosis causes a lack of proteins in the liver, which can lead to increased pressure in the blood vessels and fluid seeping into the abdomen.

Severe Lung Conditions Conditions such as emphysema can lead to edema if pressure in the lungs and heart gets too high.

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Fluid Overload Indicates Heart Issue

“When symptoms appear to be more systemic, when the entire body is affected by an overload of fluid volume, those are the kinds of things that may be heart-related,” he said.

A condition that’s often underdiagnosed even in the face of these symptoms is pulmonary hypertension, or high blood pressure in the lung.

“Essentially the right side of the heart fails because that side isn’t built to withstand high blood pressures,” said Dr. Bhakta. “The pressures in the lung can climb so high that the right side of the heart can no longer push blood through the lungs’ circulatory system.”

Other heart problems that can be related to leg swelling include:

  • Atrial and ventricular septal defects holes in the heart that are typically diagnosed at birth
  • Certain abnormal heart rhythms
  • Left heart failure: Swollen ankles and legs can be a symptom

Causes And Signs Of Edema

Edema means swelling. The condition called edema arises when part of the body becomes swollen because fluid gathers in the tissue. It most commonly affects the arms and legs. That is called peripheral edema.

Common early signs of peripheral edema include the following:

  • An arm or leg starts feeling full or heavy.
  • The arm or leg starts to look swollen.
  • When you press the swelling, it leaves a dent.
  • Your clothing or jewelry starts to feel tight and uncomfortable.
  • The skin near the edema feels tight or warm.
  • It becomes harder to move any joints that are affected.
  • There is a sensation of tautness or even pain in the surrounding area.

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You’re In Kidney Failure

Your kidneys are responsible for balancing fluids in your body and moving fluid you don’t need out of your system. When one or both aren’t functioning properly, you might end up with swollen feet.

“Normally people go home and put their feet up, and the body reabsorbs that little bit of extra fluid, and the kidneys just get rid of it,” explained Dr. Marcussen. ” kidney problems, your body has trouble getting rid of that fluid, then that swelling is more marked and more dramatic. A lot of people have swelling other places too, like their hands and face.”

You would think that treatment for kidney disease would help the problem, but not so with dialysis, which is often required for advanced cases of kidney failure. Dialysis machines are like artificial kidneys, performing the same tasks that your kidneys no longer can. Even on dialysis, though, your body can’t get rid of enough fluid.

This is when medications can help. “People who have heart failure or kidney problems are often put on diuretics,” said Dr. Marcussen, of medications that increase the amount of water and salt you excrete in your urine. “Basically they help the kidneys dump fluid.”

How Is Heart Failure Treated

An Osmosis Video: Congestive Heart Failure (CHF) Explained

Your treatment will depend on the type of heart failure you have and, in part, what caused it. Medications and lifestyle behaviors are part of every treatment plan. Your healthcare provider will talk to you about the best treatment plan for you. Treatment is the same, regardless of gender.

As heart failure gets worse, your heart muscle pumps less blood to your organs, and you move toward the next stage of heart failure. Since you cant move backward through the heart failure stages, the goal of treatment is to keep you from moving forward through the stages or to slow down the progression of your heart failure.

Stage A treatment

The usual treatment plan for people with Stage A heart failure includes:

  • Regular exercise, being active, walking every day.
  • Stopping the use of tobacco products.
  • Treatment for high blood pressure .
  • Treatment for high cholesterol.
  • Not drinking alcohol or using recreational drugs.
  • Angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions.
  • Beta-blocker if you have high blood pressure.

Stage B treatment

The usual treatment plan for people with Stage B heart failure includes:

Stage C treatment

The usual treatment plan for people with Stage C HF-rEF includes:

If the treatment causes your symptoms to get better or stop, you still need to continue treatment to slow the progression to Stage D.

Stage D treatment

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