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What causes swelling in lower limbs of a person with normal BP?

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Posted on Tue, 26 May 2015
Question: The other doctor on line said possible heart problems but the doctor I saw on may 1 and on may4 said there was no blood clot and no problem with the heart only swelling of the feet and ankles the online doctor gave such a vague diagnosis and gave no other possible explanation and I feel like I paid for nothing. If this is not remedied I will have to report the incident
the other doctor said there was no blood clot and there was no heart problem. I have not been flying nor standing for more than two hours and was fine that evening but upon waking up I noticed both feet and ankles were very swollen with a burning sensation to the outside of both ankles about 1 inch above the ankle bone
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Answered by Dr. Prakash H Muddegowda (1 hour later)
Brief Answer:
Can be associated with hypertension and heart failure commonly

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows.
1. Swelling in both lower limb is commonly seen in patients with hypertension due to back pressure from right side of heart (Right heart failure). This could be the reason, heart problems, had been thought of initially.
2. Its due to reduced venous return in lower limb and fluid moving out due to increased hydrostatic pressure and edema and hence swelling of limb.
3. 2-3 pillows below legs overnight, so that limb is above level of heart will reduce swelling. If persistent, then only diuretics like frusemide will be necessary.
4. Standing or sitting for longer duration can induce or increase swelling. If the swelling is present for longer duration, it can damage skin and cause itching and ulcer formation. At present, the cause must be limb in lower position for longer duration with reduced movement.
5. Reduced venous return is the main cause for swelling. It will reduce with limb elevation and frusemide. If painful, then deep vein thrombosis or blood clot needs to be ruled out.
6. Good to know, Doppler for thrombus is negative. Continue with limb elevation and diuretics like complete reduction of swelling.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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What causes swelling in lower limbs of a person with normal BP?

Brief Answer: Can be associated with hypertension and heart failure commonly Detailed Answer: Hi, Thanks for asking. I am Dr. Prakash HM and I will be answering your query. Based on your query, my opinion is as follows. 1. Swelling in both lower limb is commonly seen in patients with hypertension due to back pressure from right side of heart (Right heart failure). This could be the reason, heart problems, had been thought of initially. 2. Its due to reduced venous return in lower limb and fluid moving out due to increased hydrostatic pressure and edema and hence swelling of limb. 3. 2-3 pillows below legs overnight, so that limb is above level of heart will reduce swelling. If persistent, then only diuretics like frusemide will be necessary. 4. Standing or sitting for longer duration can induce or increase swelling. If the swelling is present for longer duration, it can damage skin and cause itching and ulcer formation. At present, the cause must be limb in lower position for longer duration with reduced movement. 5. Reduced venous return is the main cause for swelling. It will reduce with limb elevation and frusemide. If painful, then deep vein thrombosis or blood clot needs to be ruled out. 6. Good to know, Doppler for thrombus is negative. Continue with limb elevation and diuretics like complete reduction of swelling. Hope it helps. Any further queries, here to help again. Dr. Prakash HM