7. Swelling in Ankles, Feet, and Legs (Edema)
Swelling in the lower body is one of the most visible signs of heart failure. It usually begins in the ankles and feet, as gravity pulls fluid downward. Over time, swelling may extend up the legs. This happens because the heart cannot pump blood effectively, leading to a backup of fluid in the veins. The kidneys also receive less blood and retain salt and water, which adds to swelling.
Patients may notice that their shoes or socks feel tighter in the evening. Some describe a “heavy” feeling in their legs. In advanced cases, pressing the skin leaves a noticeable dent — this is called pitting edema.
A real-life example is Mrs. Lucy, a 65-year-old retired school principal. She first noticed that her slippers didn’t fit by evening. She thought it was just age or standing too long in the kitchen. But soon, her ankles and calves looked swollen every day. When she finally went for a check-up, doctors found she had right-sided heart failure. With diuretics and diet changes, her swelling reduced.
Leg swelling is often ignored as something “normal,” especially in older adults. But in heart failure, it is a warning sign. Persistent swelling that doesn’t go away with rest should never be dismissed. It shows that the heart and kidneys are under strain, and medical care is needed.