Are Swollen Feet a Sign of Heart Failure?

There are many reasons feet might suddenly swell or be chronically swollen, and congestive heart failure (CHF) is one of them. This chronic condition results in the heart being unable to pump enough blood to service your body's needs. The reduced force of blood through the circulatory system causes fluids to get trapped inside tissues and pool in your legs and feet.

Swelling in the legs and feet is specifically referred to as peripheral edema. It can be the first sign of heart failure in some people.

Once heart failure is diagnosed, it is important to monitor increases in body weight caused by fluid overload. Worsening edema is generally an indication of worsening heart failure.

This article looks at the signs and symptoms of edema in people with heart failure, including when it is time to see a healthcare provider. It also explains how heart failure causes peripheral edema, and details other possible causes of edema and swollen feet.

Swollen Feet and Other Symptoms

When you have peripheral edema, the retention of fluid in the lower extremities is bilateral, meaning that both feet/legs are swollen. The symptoms tend to develop gradually and may not be obvious at first.

Among the early signs of peripheral edema:

• Your legs may start to feel full or heavy.
• Your feet and lower legs may start to look swollen.
• When you press the swollen skin, it leaves a dent.
• Your socks, leggings, or pants may feel tight and uncomfortable.
• The skin may feel tight or warm.
• It may be harder to flex your ankles, toes, or feet.

Swollen feet and legs are common signs of heart failure, but they are not the only ones. Others worth noting include:

• Shortness of breath with activity or lying down
• Persistent cough with foamy mucus
• Fatigue and weakness
• Abdominal bloating
• Rapid weight gain
• Nausea and loss of appetite
• Rapid or irregular heartbeats
• Difficulty concentrating

How Does Heart Failure Cause Edema?

With heart failure, the heart is unable to adequately pump blood out through the arteries and back in through the veins. As a result, blood can start to pool at the lowest part of the body, namely the lower legs and feet, causing swelling.

In addition, heart failure reduces blood flow to the kidneys, which causes the kidneys to retain sodium and water, leading to fluid overload. This not only accumulates in the lower extremities, but also causes the build-up of fluid in the lungs (pulmonary edema) or heart (cardiac edema).

When to See a Healthcare Provider

The sudden or persistent swelling of your feet is not something you should ever ignore.

Seek immediate care if any of the following occurs with swollen legs or feet:

• The swelling is sudden and severe.
• The swelling causes pain with severe redness and heat.
• You have chest pain or irregular heartbeats.
• You have difficulty breathing.
• You are coughing up pinkish foam or blood.

Other Possible Causes

While swelling could be the result of heart failure, it may also be due to something else. For example, these may be signs of a condition known as deep vein thrombosis (caused by a blood clot in the leg) or cellulitis (and severe skin infection that causes swelling similar to edema).

Other causes of swollen feet that may be considered include:

• Sitting in one position for too long: Sitting for a long time puts your knees, thighs, and hips in a position that compresses veins at certain junctions, trapping blood in the lower extremities.
• Medications: Certain blood pressure or pain medications can cause fluid retention and swelling.
• High salt intake: Excess sodium causes excess fluid retention.
• Pregnancy: As the baby grows, the uterus puts pressure on the blood vessels in the lower half of your body.
• Thyroid disease: Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) cause hormonal imbalances that can lead to fluid retention.
• Liver disease: Cirrhosis (advanced scarring of the liver) can cause the build-up of fluid in the abdomen which, in turn, can contribute to the onset of edema.
• Chronic kidney disease: When the kidneys do not remove enough sodium and water from the body, the pressure in blood vessels can start to build up, leading to edema.
  

Prognosis

Peripheral edema is a concern in people with heart failure, mainly because it tends to get worse as heart failure progresses. As such, peripheral edema is often regarded as a marker of disease progression in people with heart failure.

Studies suggest that with proper treatment, people with heart failure can live for years with varying degrees of disability or complications. According to a 2017 review of studies in BJGP Open, among people diagnosed with heart failure:

• Between 80% and 90% live for at least one year.
• Between 50% and 60% live for at least five years.
• Around 30% live for at least 10 years.

Several factors can contribute to higher and lower survival times, including a person's age (with people under 65 living longer than those over 65) and the functional capacity of heart.

Summary

The swelling of the feet, ankles, and lower legs is a common sign of heart failure. The condition, known as peripheral edema, is caused by the reduced force of blood flow through the body, causing blood to pool in the lower extremities.

Edema can be caused by things other than heart failure and needs to be assessed by a healthcare provider. If heart failure is diagnosed and properly treated, people can live for five years, 10 years, or even more.

A Word From Verywell

It can be alarming to notice a substantial change in your body, such as swollen feet. Heart failure is a major cause of swelling, but other less serious conditions can also cause swelling.

Whether the cause is a heart condition or a recent change in medication or diet, the swelling can be managed. It’s important for a healthcare provider to diagnose the cause so you can get treatment as soon as possible.