Why do feet swell in heart disease?

Swelling of the feet is caused by impaired venous circulation in the lower limbs; thus, prolonged pressure on the lower limbs can also lead to foot edema. Wearing high-heeled shoes—common among women—can similarly contribute to foot swelling. If neither external compression of the lower limbs nor high-heeled footwear is involved, poor blood reflux due to hypertension may be responsible for the swelling.

Why do patients with heart disease develop foot swelling?

The most common cause of foot swelling in patients with heart disease is cardiac insufficiency—specifically, right ventricular dysfunction. In such cases, impaired venous return leads to fluid accumulation and subsequent edema in the feet. Clinical signs of right heart failure include jugular venous distension and engorgement. Edema typically begins in the feet and legs and may progressively extend upward, involving the entire body; patients may also develop pleural effusion and ascites. Nevertheless, when evaluating foot swelling in cardiac patients, other potential causes must be ruled out—including hypoalbuminemia (which may stem from hepatic or renal dysfunction), hypothyroidism, and deep vein thrombosis of the lower limbs—requiring a systematic differential diagnosis.

If foot swelling is attributable to heart disease, it signifies the presence of heart failure, necessitating prompt pharmacological intervention. Diuretics should be initiated first to promote fluid excretion and alleviate edema. Additionally, patients should elevate their legs, and treatment should include positive inotropic agents and vasodilators to improve cardiac function—and thereby reduce foot swelling.

Patients are advised to remain predominantly bedridden to reduce cardiac workload and strictly limit dietary sodium intake while avoiding excessive fluid consumption. We hope this information proves helpful.