Help! My Legs Keep Swelling

If your legs keep swelling (edema), it means they’re retaining fluid that makes them puff up, the skin turning shiny and taut. Not all causes of swollen legs are serious. You can develop them if you eat too much salt or don’t get enough exercise. You can also develop them if you sit or stand for long periods of time, such as doing assembly line work or traveling on an intercontinental flight.

However, swollen legs can also indicate serious circulation problems in the lower body. In the case of vein disease, the problem starts out small, with the sluggish blood flow of chronic venous insufficiency (CVI) and varicose veins. Then it grows more serious, adding on deep vein thrombosis (DVT) and skin ulceration. It can also have other systemic effects.

Swollen legs may also be a sign of peripheral artery disease (PAD), which has a totally different cause than the vein problems but also affects circulation.

At Northwest Houston Heart Center, cardiologists Dr. A. Adnan Aslam and Dr. Roy Norman see all manner of leg swelling at their four Texas office locations. Whether you have varicose veins,  DVT, or PAD, the team specializes in diagnosing and treating the underlying causes. Here’s how they address this complex topic.

Serious causes of edema

Circulatory system problems on either the arterial or venous sides of the loop can lead to edema that indicates a serious underlying cause for the symptom.

Chronic venous insufficiency

The veins of the circulatory system pump deoxygenated blood back to the heart from the extremities. Unfortunately, though, they have to pump it against the pull of gravity. To get around the problem, they contain a series of small valves that snap tightly shut after the blood passes by so it won’t backtrack.

The valves, though, can be damaged and then can’t close completely. Blood is now able to flow backward, becoming sluggish and pooling around the damaged valve and engorging the vein at that site. This state is called venous insufficiency, as blood flow is insufficient to support the body’s needs.

When blood pools in superficial veins, those near the skin's surface, they appear as colored, ropy protrusions on the thighs and calves and are known as varicose veins. Varicose veins are leaky; they ooze blood and fluid into the nearby tissues, leading to edema.

Varicose veins can also lead to deep vein thrombosis (DVT), in which a clot develops in one of the deep leg veins, slowing down blood flow even more. The clot may completely block flow, or it can break away from the vein wall and travel to the lungs, causing a life-threatening pulmonary embolism. If you experience sudden swelling in one leg along with pain in the calf muscle, you probably have DVT and need immediate medical help.

Congestive heart failure

In congestive heart failure, one or both of the heart's lower chambers can’t pump blood well and thus deliver enough oxygen and nutrients to the body’s tissues. Because the flow is weak, blood can back up in the legs, ankles, and feet, leading to edema.

With congestive heart failure, you may also experience swelling in the stomach area, as well as fluid buildup in the lungs, the latter known as pulmonary edema.

Peripheral artery disease

Peripheral artery disease is a common condition in which blood flow to the extremities is reduced due to narrowed arteries. This can lead to claudication (pain while walking), as well as other symptoms.

PAD is caused by atherosclerosis, a buildup of a fatty plaque on the artery walls. This plaque hardens, narrowing the artery and causing the heart to work harder to pump the same amount of blood through the conduit.

PAD can lead to other complications, such as critical limb ischemia, where an injury or infection causes tissue death from open sores on the limbs that don’t heal. If the case is severe, you may require amputation of the limb.

PAD can also lead to heart attack and stroke by blocking the blood vessels in the heart and brain.

The key to beating edema is to act quickly. If you notice any swelling in your extremities, especially if it’s accompanied by pain, weakness, and other symptoms, you need to come into Northwest Houston Heart Center so we can diagnose the problem and begin treatment early, when it’s more effective. 

To start, give us a call book online today. You can also text us at 832-402-9518. We have offices in Tomball, Cypress, Magnolia, and The Woodlands, Texas.