Pitting Edema, Lowering EF, Shortness of Breath --Doctors Lounge(TM)

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Forum Name: Heart Failure

Question: Pitting Edema, Lowering EF, Shortness of Breath

carmstrong03 - Fri Jul 06, 2007 4:10 pm
I am a 34 year old female. I have severe pitting edema of my lower legs and ankles mainly my left side, muscle weakness and fatigue. I was recently rushed to an ER for left leg swelling and was told possble Congestive Heart Failure. I visited a Cardiologist for an Echo and Stress test. My ejection fraction is 54 compared to 59 four years ago and the stress test was normal. Lab work shows my sugar is normal, no protein in my urine. I do however have a positive ANA, anemia and high Sed Rate. I am very confused about all of this. If my symptoms are not heart related what other possiblities should I address? Should I be concerned with the lowering ejection fraction or is it normal to decrease with age?
Marceline F, RN - Sat Jul 07, 2007 4:26 am
Dear carmstrong03, From the fact that you had an echo done 4 years ago leads me to believe you have had concerns about your health for some time. While you understand correctly that the heart plays a large part in circulation, and that congestive heart failure can give you the symptoms you describe, there is another major organ of the body that plays a huge role in fluid retention - especially evident in dependent extremeties. (The symptoms show up particularly noticeable in legs since they are "down", or in a dependent position, most of the time.) Have you had any tests done concerning kidney health? The kidneys have the incredible task of being the garbage trucks for the body, eliminating wastes and toxins. If the body has an infection that affects the kidneys, they can cause problems like back up of fluid in the legs and hands. Having an abnormal ANA or SED rate would be worth asking your doctor for further information. There are simple tests that may help clarify these findings. In any event the swelling in your legs is not normal, and deserves a closer look.
carmstrong03 - Sat Jul 07, 2007 8:56 am
Marceline Thank you for your quick response. I have had concerns, the swelling in my legs has been going on for quite some time. I have had testing done on my kidneys and my kidneys are normal. Any other ideas?
Marceline F, RN - Sat Jul 07, 2007 12:22 pm
Dear Carmstrong03, Are your legs reddened and warm to touch? Does the skin look normal? What are the rest of your lab values on your CBC (you mention anemia)? More importantly, what does your primary doctor think? You apparently are being followed by a practitioner - what is she/he suggesting may be the problem? Sounds like your concerns would be best addressed by a physician who can assess your edema directly, and order appropriate tests.

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