Are Swollen Feet a Symptom of Congestive Heart Failure? - Health Central
If you've ever been trapped in a seat on a long airplane ride, you might have wobbled off the flight with swollen ankles and feet. It's common: When you sit for long periods at a time, the force of gravity pulls the fluid in your blood downward, causing it to pool in your lower extremities. Most times, this is relatively harmless and quickly goes away once you start moving around.
But swollen feet can also be a symptom of congestive heart failure, a progressive and potentially life-threatening disease, "where the heart can't pump the blood well enough to support the needs of the body," says Anum Minhas, M.D., who specializes in cardiovascular disease in women at Johns Hopkins Medicine in Baltimore, MD.
About 6.2 million adults in the U.S. have heart failure, according to the Centers for Disease Control and Prevention, and it's the leading cause of hospitalization in people over the age of 65. Since the condition can get worse over time, it's important to get the right diagnosis and appropriate medical care. Here's a look at what congestive heart failure is and what your swollen feet may (or may not) signify.
Why Feet Swell
How Can Congestive Heart Failure Cause Swollen Feet?
The heart is a muscle, and its main job is to pump blood throughout the body. But if the heart isn't working as well as it should, the amount of blood flowing out of the heart slows, making it difficult for blood that is returning to the heart through the veins to pass through, according to the American Heart Association (AHA). "When the heart is not pumping up to speed, instead of going forward into and out of the heart, blood backs up," explains Dr. Minhas.
This backup of blood causes congestion, or an accumulation of body fluid, which can lead to swelling (edema). And it doesn't just occur in the feet. "[Blood] can also settle in the ankles, legs, belly, and lungs," adds Dr. Minhas. Swelling in the feet, legs, and ankles is also known as peripheral edema.
In addition, heart failure can also mean the kidneys are not able to process sodium and water as well. That creates more blood volume, which can also increase swelling in the feet and other parts of the body, per the AHA.
Other Causes
Other Conditions That Cause Swollen Feet
Peripheral edema isn't unique to heart failure. Long plane flights or car rides or standing for long periods of time can also make your feet and ankles swell. So can being pregnant, having obesity, or certain medications such as antidepressants, blood pressure drugs like calcium channel blockers, hormones like estrogen, and steroids.
In addition, swollen feet can be the result of serious medical conditions, including:
Additional Signs
Other Symptoms of Congestive Heart Failure
Swollen feet aren't the only sign that you may have congestive heart failure. Per the Cleveland Clinic, other symptoms of this condition can include:
Chest pain
Dry, hacking cough
Dizziness even at rest
Fatigue
Heart palpitations
Loss of appetite or upset stomach, including nausea
Shortness of breath, even when lying down
Swelling in other parts of the body south of the heart, including the ankles, legs, and belly
Weight gain
Seeking Help
When to See a Doctor
How can you tell if your swollen feet are a sign of something potentially serious? "If swelling persists over a period of weeks and it's slowly worsening, especially if you have any other symptoms of heart failure (like the ones above), it's important to see your doctor," says Marat Fudim, M.D., an assistant professor of medicine and cardiology at Duke Cardiology Clinic in Durham, NC. "Fluid retention often signals to us that not only might you have heart failure, but it may already have progressed to an advanced stage."
Your doctor will perform a physical exam and take a full history. Diagnosing congestive heart failure may include the following tests to determine just how well your heart is pumping, per Brigham and Women's Hospital.
Computed tomography (CT) scan. This type of diagnostic imaging uses low-intensity X-rays to create multiple, detailed pictures of the inside of your body.
Echocardiogram. This test uses high frequency sound waves (ultrasound) to make pictures of your heart.
Electrocardiogram (EKG or ECG). This test checks the heart's rhythm and monitors its electrical activity (your heart produces electrical signals every time it beats).
Magnetic resonance imaging (MRI) scan. This non-invasive scan uses powerful magnet and radio waves to interact with your body's water and fat molecules to create detailed images of organs and tissues in your body.
Positron emission tomography (PET) scan. This test uses a radioactive drug called a tracer to show both typical and atypical metabolic activity. Per Mayo Clinic, PET scans can reveal areas of decreased blood flow in the heart.
Treatment Options
Treatment Options and Preventive Strategies
Diuretic medications are used to treat swollen ankles and feet by helping the body get rid of excess fluids by peeing them out. In addition, your doctor may recommend that you move around more, which can help reduce and prevent further swelling, says Dr. Minhas.
If you're diagnosed with heart failure, you'll likely also be given additional medications, including ACE inhibitors to lower blood pressure, beta-blockers to slow down heart rate and lower blood pressure, and SGLT2 inhibitors, which are diabetes drugs that have recently been shown to treat heart failure, says Dr. Minhas.
In addition, a healthy lifestyle can significantly slow heart failure progression. "While heart failure cannot be cured, you can halt or slow the disease process down, if you stop smoking, lose weight, start an exercise routine, and avoid excessive alcohol, which can contribute to fluid retention," says Dr. Fudim.
Bottom Line
Swollen feet can be a warning sign for heart failure (or other serious illnesses). If it persists for weeks and/or happens in conjunction with other signs of heart failure, speak to your doctor as soon as possible. "Don't ignore it if it's out of proportion to what you are used to experiencing. Swollen feet warrant an evaluation," says Dr. Fudim. The sooner you get a diagnosis, the faster you can get the help you need to address the condition and slow the disease process down.
This article was originally published November 27, 2023 and most recently updated November 28, 2023.
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