Swelling of feet
Swelling of feet is a very common symptom of patients with heart problem. It can also be due to various other reasons, such as kidney problem. However, it commonly occurs in patients with heart disease. Patients start to see this developing gradually over a period of weeks to months. Initially, it happens at the end of the day, but when this gets ignored, it will progress to occur during morning aswell. So it is important that patient seeks an opinion of a cardiologist at the earliest to assess the heart.
The main cardiac reason for swelling of feet is heart failure. Heart failure is a term used when your heart is not pumping blood, as it should be. The heart has 2 pumping chambers, called ventricle- right and left. When any one of the pumping chambers is not functioning well, you can develop swelling of feet. The Cardiologist will do a battery of tests to find out the reason for the heart dysfunction.
One of the commonest reasons for dysfunction of heart is coronary artery disease, which is due to blockages in the small arteries supplying the heart muscle. This can be diagnosed by doing a coronary angiogram, which will identify the blockages for the cardiologist to decide on further management. In most situations, the blockages can be treated by a procedure called Percutanoeus coronary intervention (PCI), commonly known as angioplasty with stent insertion. This will improve the blood supply to the heart muscle, thereby improving the functioning of heart.
Mrs. Saranya, a 50-year-old lady presented to the Cardiology department at Apollo hospital, with selling of feet for 1 month. On further questioning, she also had mild chest tightness on exertion. An echocardiogram confirmed there was dysfunction of left ventricle and a coronary angiogram confirmed multiple blocks in her coronary arteries. She was successfully treated with angioplasty using multiple stents under the guidance of a specialized imaging technique called Optical Coherence Tomography (OCT). This allows visualizing the inside (lumen) of the coronary artery at 360 degrees with a tiny camera connected to a thin tube. This identifies the blockages precisely and helps to position the stent accurately at the level of blockage and to make sure the stent is fully expanded with the balloon.After the stent insertion, the patient was discharged in 2 days and her swelling disappeared in few days. Her quality of life improved dramatically that she went back playing golf as she did few months before.
There are also other cardiac reasons for heart failure, such as cardiomyopathy (heart muscle dysfunction), valve dysfunction, uncontrolled hypertension, and use of excess alcohol- all of which can lead to swelling of heart. In selected group of patients, who have irreversible heart failure, a special pacemaker called biventricular pacemaker (also called as CRT) can improve symptoms. If no other treatment options available for patients with heart failure, they can have heart transplant, to improve the quality of life.