akle edema causes?

Question

A 55 plus year old man with normal BP, overweight, sedentary, no kidney problems, no DVT, aortic valve stenosis 20% experiencing ankle edema. Generally reduces after exercising about 1 hour per day. Could progression or aortic stenosis cause it ? What kind of workup recommended.

Answer 1

the venis return could have slowed down with age. could add a diuretic to overcome this problem

Answer 2

Generally speaking ankle edema, graded 1, 2, 3, or 4+ is not a diagnosis per se. It is a secondary symptom. Like itching is to a mosquito bite. It can have multiple reasons such as CHF (Congestive Heart Failure), right -sided or left- sided, being overweight and sedentary especially if the person sits alot from venous status. (Where blood pools in the legs). It could be from kidney disease, or from large tumors in the abdomen that tend to cut off the circulation of both blood and lymph to the extemities (legs). People with liver & blood diseases can also have ankle edema. Bottom line however is that sometimes exercise can create "third space fluid losses" and it could be that simple. If the person is exercising an hour per day I would not consider that sedentary unless they are a couch potato the other 23 hours of the day. I think one could start with a CMP, (comphrensive metabolic panel), take a good patient history to find out what meds are being taken because the etiology could be med related, BP's, pulses, O2 sat, and progress to a good physical with palpations of the liver, and abdomen, etc, and then continue with a chest x-ray to see the size of the heart, check lungs for pathology, check heart sounds, an ultra sound of the heart, & abdomen might suggest further study but usually one takes a step by step approach and continues to rule out instead of an all inclusive approach. Ultra sounds and scans only become necessary as later steps. Aortic stenosis might aggrevate the situation but doesn't have to be the sole cause. I would like to know if the man has a 1,2,3,or 4+ ankle edema, that tells more and any other underlying problems. You mention he has no DVT however that can change in no time flat. Sometimes there are no clear cut answers because there are too many variables that have to be sorted thru to get the equation set up! Also sometimes tests come back normal but a second time they don't. There are no "givens" in medicine, except for the moment.

Answer 3

Hello, hope this helps.

Foot, Leg, and Ankle Swelling: Common Causes

Foot, leg, and ankle swelling is common with the following situations:

Prolonged standing
Long airplane flights or automobile rides
Menstrual periods (for some women)
Pregnancy -- excessive swelling may be a sign of pre-eclampsia (a serious condition that includes high blood pressure and swelling; sometimes called toxemia)
Being overweight
Increased age
Injury or trauma to your ankle or foot
Swelling of the legs may be a sign of heart failure, kidney failure, or liver failure. In each of these conditions, there is too much fluid in your body.

Other conditions that can cause swelling to one or both legs include:

Blood clot
Infection of the leg
Venous insufficiency (when the veins in your legs are unable to adequately pump blood back to the heart)
Varicose veins
Burns including sunburn
Insect bite or sting
Starvation or malnutrition
Surgery to your leg or foot
Certain medications may also cause your legs to swell:

Hormones like estrogen (in birth control pills or hormone replacement therapy) and testosterone
A group of blood pressure lowering drugs called calcium channel blockers (especially nifedipine, but also amlodipine, diltiazem, felodipine, and verapamil)
Steroids
Certain antidepressants, namely MAO inhibitors (such as phenelzine and tranylcypromine) and tricyclics (including nortriptyline, desipramine, and amitriptyline)

Be blessed.

Answer 4

Hi there !

Ur concern is very well understood...
Usually the oedema of the ankles is caused by :

cardiac lesions
renal problems
.anaemia and secondary cardiac pump failure... and
peripheral venous return filure..

since you yourself have ruled out cardiac, renal problems....

ANAEMIA leading to pedal oedema is a common cause in India , especially in middle aged...This happens like this...

lesser diet / or bleeding......causing lesser Haemoglobin in the body...causing...more cardiac pumping to compensate for improper oxygenation.....and ...heart over works....ultimately heart failure if not treated in the right time ...

Another cause for pedal oedema (ankle swelling) is the local valve failure..wherein the valve does not function properly at the inguinal area (saphenous opening )..causing improper return of the venous blood to the heart and ...causing blood stagnation at the feet level .... whenever you are standing for long time..

In the cases of anaemia...treat the cause of anaemia and you
will win the battle....

In the last cause mentioned.....maybe some amount of relaxation./ resting in the lying done posture will ease the problem...

Ultimately...your consultant is THE BEST JUDGE...
Talk to him...

Best wishes...

Answer 5

when there is avs 20% , i dont think bp would be normal.
work up--- the person is recomended to wear tight stockings to prevent fluid accumilation. and have three continuous bp checkups to rule out htn.
AOTIC STENOSIS- RAISED CAPILLARY HYDROSTATIC PRESSURE- ACCUMILATION OF FLUID IN ECF- ANKLE OEDEMA

HENCE PROGRESSION OF AVS would definstely worsen the condition.
ok

Answer 6

water my leg I can go up 4 pound in night