Leg swelling an early symptom of Heart Failure-By Dr Harold Gunatillake

‘Heart failure occurs when the heart cannot pump enough blood to the body to provide enough nutrition and oxygen’.

Your legs can swell temporarily from injuries, inflammations, prolonged standing or sitting on the plane, or for no reason at all. These are due to temporary lymphatic stasis situations and need no special investigations and treatment are required.

What is important is when both legs gradually swell with pitting oedema, which is a depression caused due to pressure with your thumb, due to causes not in the legs, but more central in the body, in middle age and beyond.

There is pitting oedema when you are on beta-blockers and Calcium channel blockers and other drugs. Do not mistake such mild swelling of legs is due to heart failure

As home measures, you could put your legs on pillows to raise above heart while lying down, and following a low salt-diet, and wearing support stockings, as temporary measures, will ease, but the root cause of the issue needs investigation and management.

The best weapon in the fight against swollen legs is a simple one: walking and moving to improve circulation which sweeps up the collected fluid towards the right heart.

One reason Sri Lankans get this issue in their middle age is due to neglect in proper health habits, taking life for pleasures, enjoying calorie dense salty foods in restaurants and other food outlets, leading a sedentary life with no concern about your body weight problems.

So, one fine day, you will notice your bad lifestyle appearing as early mild swelling of both legs, with and without other symptoms.

The commonest condition that causes swelling of both legs is due to a failing heart among other so many causes. The swelling is due to the excess fluid in your leg tissues- often caused by congestive heart failure. The swelling is noticed in the most dependent parts of your body being your legs. This swelling and puffiness of tissues in the other parts directly under your skin appears later.

You need to change your daily diet to a healthy one.

Avoid drinking sugar and high fructose corn syrup included soda drinks. Avoid frozen readymade foods with artificial trans fats, go on a plant-based diet, avoid refined carbs, alcohol, red meat, and processed meat. Avoid adding salt and using too much of sauces in your food.

Due to the high dietary sugar consumption as carbs and dietary high fat food consumption, arteries in your body tends to get thickened and narrowed with added coating of plaques. This condition we call arteriosclerosis and atherosclerosis, respectively.

This could happen in your coronary arteries like the arteries in the rest of your body.

Such coronary arteries, with high blood pressure resulting from narrowing and thickening of arteries in the body, gradually leaves the heart too weak or stiff to fill and pump blood properly.

Without proper management at this stage, fluid tends to collect and builds up in lungs and legs. The fluid buildup can cause shortness of breath and swelling of the legs and feet. Poor blood flow may cause the skin to appear blue (cyanotic).

The word congestive heart failure is named because of this congestion in your lungs due to heart failure.

This may present as asthma, and we refer to the condition as cardiac asthma.

The heart muscles get thickened, and the plain X-rays of the chest will reveal the heart as boot-shaped because of the enlarged left ventricle of your heart due to thickening or hypertrophy of your heart muscles.

The heart now become enlarged, and the next stage is referred to as heart failure a life- threatening situation.

The most common cause of congestive heart failure is coronary artery disease. Risk factors for coronary artery disease include elevated levels of cholesterol and/or triglyceride in the blood and high blood pressure.

Proper management at this stage can improve and reverse the life-threatening situation and to live long.

Lifestyle changes, such as losing weight, exercising, reducing salt in your diet can improve your quality of life.

The scenario at this stage is for most Sri Lanka to see a heart specialist, get investigated including medication.

Most people are complacent and satisfied that proper treatment is being taken by seeing a specialist, but the root cause of the problem remains due to the ignorance and continuing the same lifestyle, without changes.

Although this situation cannot be cured, you can make healthy lifestyle changes and take certain medication to manage the condition.

The best drinks for your heart are: Drink: Tea. …Drink: Coffee. …

Drink: Beetroot Juice. …Do not Drink: Soda. …Do not Drink: Energy Drinks… Do not Drink

(Too Much): Alcohol.

Foods you should avoid when you have heart failure are those foods that increase fluid retention, contribute to blood sugar problems, or lead to obesity.

Salt (Sodium) When you have heart failure, you absolutely must avoid salt. …

Potato Chips. Potato chips represent a classic “worst food” for people with heart failure because they are high in both fat and sodium. …

Wine…. Drinking wine is good when your heart is healthy. Alcohol can make this problem

worse by slowing down your heart rate. That is why most doctors recommend you avoid all types of alcohol (including beer and mixed drinks) when you have heart failure.

White Bread….. Eating highly processed grains like white bread does your body no favors

because these foods lack healthful fiber. Dietary fiber (also called “roughage”) helps your body regulate blood sugar levels and scrub cholesterol from your arteries. When you have heart failure, you should avoid white bread, white rice, regular pasta, many boxed breakfast cereals, and other processed grains.

Water. Drinking a lot of water (or any beverage) leads to excessive fluid levels inside your body, which increases the workload on your weakened heart. If you have heart failure, you should carefully manage your fluid intake, including tracking all the beverages you drink.

Best heart-healthy diets include: More omega-3 rich foods (such as fish: especially char, trout, salmon, and mackerel; flaxseed; canola oil; soybeans; walnuts)

Extremely limited amounts of saturated and trans fats, cholesterol, red meats, and sweets There are medications to avoid when you have heart failure:

Alka-Seltzer, Antihistamines, antiarrhythmic medications, Calcium channel blockers, Nonsteroidal anti-inflammatory drugs.

Some heart failure medicines can cause potassium in the blood to rise. Too much potassium, called hyperkalemia, can cause such symptoms as weakness, nausea, diarrhea, pain, paralysis, difficulty urinating, and irregular heartbeat.

Soaking or boiling vegetables and fruits in water before eating Avoiding foods labeled with KCI potassium chloride), K+, or potassium Avoiding foods high in potassium.

You can avoid heart problems by changing your lifestyles to a healthy one. If you neglect and get into coronary heart disease and heart failure this video talk may be useful

Stay safe and goodbye for now.

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