What causes swollen feet and leg?
I request your suggestion for sheding light on possible cause of swollen feet and leg, any further diagnosis and medications.
More information necessary
I am Dr. Prakash HM and I would like to answer your questions.
Pedal edema if bilateral is usually a dependent edema and commonly of cardiac cause. If there is no history of hypertension or any ischemia of heart disease then cardiac causes can be ruled out. However, ECG or echo cardiography if done would be helpful.
Renal parameters are slightly raised. To evaluate further, an urine protein and microscopy is necessary.
Facial puffiness is indicated in case this is related. Is it present?
Any prominent veins in legs?
Can you answer these above questions regarding hypertension, urine examination and prominent veins? .
Dr. Prakash HM
Hypertension - He had cerebral stroke in 2011. Then he started Deplatt and continuing. His recent MRI (1.5 Tesla) is normal. He has history of hypertension. His medication history is following :
Losar 25 x 1 for last one year.
Stamlo (Amplidine) 5 x 2 was started and Losatran was stopped 3-4 months back. For last two weeks Stamlo 5 was given when necessary because of low/normal pressure. His BP is checked regularly and according to the suggestion of the local doctor, it may be given if the BP is high. His BP today 116/76. What is your suggestion ?
Urine examination report is normal. No protein is found. It is ok except PUS cells 0-1/HPF and EPITHELIAL cells 1-2/HPF.
ECG is normal.
Facial puffiness is not significant. A light shadow of veins in legs are visible.
Keeping legs at elevated position reduce swolloness temporarily and a depression mark in muscle is visible when pushed by a finger.
Edema appears drug induced (Amlodipine)
Welcome back. More history of treatment and medication is helpful.
Hypertension under control is good.
I only have one question, why was drug changed for treatment of Hypertension from losar ot stamlo?
Stamlo or Amlodipine is known to cause peripheral limb edema which you have described very well. It is a calcium channel blocker.
Treatment usually advised for Amlodipine induced edema is limb elevation in sleeping position above heart level and intake of amlodipine during night times.
However third generation calcium channel blockers, have reduced risk of peripheral edema. You can discuss with your doctor regarding change of drug from amlodipine to newer generation or ACE inhibitors.
If after change, and even after three months, it does not get reduced, then we can think of those light shadow veins in legs, which I don't think is varicose veins (Small snakes like prominence)
If you have any other queries, happy to help again. If you think, you do not require further clarifications, you can close the discussion and rate the answer.
Thanks for asking
Dr. Prakash HM
The User accepted the expert's answer
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