When do swollen ankles and feet signify a heart valve problem?

by | Feb 24, 2021 | Cardiothoracic Surgery

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When tiny blood vessels in our bodies leak fluid, it pools in surrounding tissue under our skin, leading to swelling. Doctors call this condition edema. While it is not uncommon to develop swollen feet and ankles during pregnancy, after a long flight, or after eating salty food, edema can be a sign of more serious underlying issues. One of them is heart valve disease.

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How you get swollen feet because of heart valve abnormalities

The heart is a specialised muscle which pumps blood around the body. Blood from the organs and tissues of the body enter the right side of the heart, which then pumps it to the lungs. The lungs remove carbon dioxide from the blood and return oxygen-rich blood back to the left side of the heart, which then pumps the blood to all parts of the body.

This is how a healthy heart functions to pump a regular flow of oxygen-rich blood and nutrients to the organs in the body so that they can function properly. The four valves, one in each of the four chambers of the heart, open and close as the heart pumps.

When one or more of the heart valves do not perform normally, they will disrupt this regular blood flow, causing blood to back up, or flow backward. This could happen when the valve flap bulges back instead of closing tightly – a condition called prolapse. Prolapse can result in valve regurgitation, which means that there is leakage or back flow. The heart valve could also become thick or stiff, leading to a narrowing of the valve opening, inhibiting and reducing the flow of blood through the valve.

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When this happens, the kidney will respond as if there is not enough blood circulating and it will thus produce less urine and retain more fluid. This increases the volume of blood in circulation, making the heart work harder. This causes blood to back up in the blood vessels, causing fluids to leak and accumulate in various parts of the  body. This fluid accumulation will cause blood to pool in the ankles, causing swelling of the ankles and legs due to the pull of gravity, but it can also occur in other body parts, such as the abdomen and chest.

Implications of edema

Accumulated fluid can affect oxygen intake by the lungs, hence causing breathlessness and tiredness.  Fluid accumulation in the liver and digestive organs reduces one’s appetite and yet, lead to weight increase due to the additional fluid present in the body.

How can you tell if your swollen feet and ankles are due to heart valve disease

When you experience these other physical symptoms that may suggest heart valve disease, you should consult your doctor:

  • Chest pain
  • Irregular heartbeat
  • Abdominal swelling
  • Fatigue
  • Shortness of breath
  • Dizziness
  • Irregular heartbeat
  • Heart murmur (when the doctor listens to the heart beating with a stethoscope)

This article has been verified medically by Dr Lim Chong Hee, consultant cardiothoracic surgeon at Surgi-TEN Specialists, Farrer Park Hospital (Singapore).

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