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Heart Disease (Expert Forum)
Swollen Ankles
Answered by
Cleveland - OH
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Swollen Ankles
by Erik36, Apr 11, 2006 12:00AM
Dear Doctor,
Thanks for taking my question. Male 37 years old. 5'9" 210 lbs.
A week ago today my wife noticed that both my ankles were swollen. I thought nothing of it and went to work the next day assuming they would just go away. While at work I noticed that my ankles were even more swollen that the previous day. I showed co-workers my ankles and they were all concerned and suggested that I go to the ER after work.
I went to the ER and was admitted to the hospital. Bloodwork showed normal kidney and liver function. The next morning I had a stress test, a Nuclear medicine scan and an echo which were all normal. They injected Lasix through my IV and my ankles returned to normal. I was discharged the next day with no known cause for my edema. They did give me Lasix 20mg and Potassium Chloride 20mg. I have not filled them, however, because my ankles have remained normal.
The Cardiologist at the hospital was stumped. The only thing I can think of is the night before my ankles swelled, I had eight beers to drink and ate a bunch of McDonald's food.
Do you have any ideas as to what could have caused my ankle edema?
THANK YOU!
Erik
Thanks for taking my question. Male 37 years old. 5'9" 210 lbs.
A week ago today my wife noticed that both my ankles were swollen. I thought nothing of it and went to work the next day assuming they would just go away. While at work I noticed that my ankles were even more swollen that the previous day. I showed co-workers my ankles and they were all concerned and suggested that I go to the ER after work.
I went to the ER and was admitted to the hospital. Bloodwork showed normal kidney and liver function. The next morning I had a stress test, a Nuclear medicine scan and an echo which were all normal. They injected Lasix through my IV and my ankles returned to normal. I was discharged the next day with no known cause for my edema. They did give me Lasix 20mg and Potassium Chloride 20mg. I have not filled them, however, because my ankles have remained normal.
The Cardiologist at the hospital was stumped. The only thing I can think of is the night before my ankles swelled, I had eight beers to drink and ate a bunch of McDonald's food.
Do you have any ideas as to what could have caused my ankle edema?
THANK YOU!
Erik
Doctor's Answer
by Cleveland Clinic, Apr 11, 2006 12:00AM
, Apr 11, 2006 12:00AM
erik,
Thanks for the post.
Edema is caused when fluid leaks out of the vessels into tissues surrounding the vessels. There is a relationship that maintains the balance of fluid between the two that when peturbed can lead to edema. The variables in the relationship involve the amount of fluid and salts in the blood, the leakiness of the blood vessel, and the amount of proteins in the bloodstream.
Im not sure what caused the transient swelling. It was probably related to the excessive volume and salt ou took in. The good news is the rest of your workup was negative.
good luck
Thanks for the post.
Edema is caused when fluid leaks out of the vessels into tissues surrounding the vessels. There is a relationship that maintains the balance of fluid between the two that when peturbed can lead to edema. The variables in the relationship involve the amount of fluid and salts in the blood, the leakiness of the blood vessel, and the amount of proteins in the bloodstream.
Im not sure what caused the transient swelling. It was probably related to the excessive volume and salt ou took in. The good news is the rest of your workup was negative.
good luck
I stopped it for a couple of days and, sure enough, no edema in the afternoon. Problem is that my BP went sky high so I need to find a new drug for that. In the meantime, I've gone back on the Norvasc and lately the edema only seems to be occasional.
Problem with me is that I am a maintenance alcoholic and drink at least 3 strong beers (microbrew tap) per evening. Between this and overeating, I'm trying pretty hard to kill myself, but thanks to my agressive cholesterol medicating, I have outlived my expiration date and continue to have good physical ability, despite end stage CAD.
I would check your meds as a first course of action.
Last I knew you were on a statin and Niaspan and doing some hiking and that seemed to have stopped your CAD in its tracks, possibly even regressed it a bit. I give you a lot of credit for how you've kept CAD at bay with your determination.
My Cardio wants to take me off Zocor and put me on Antara (which is a new Fibrate similar to Tricor) for my low HDL(29).I am afraid to do so because I've heard that Fibrates can cause Pancreatic and Liver cancer. My HDL remains low while my LDL is in the 60's and total is 140's.
Talk to you soon.
Erik
When I swell...I look at what I ate the day before and if any meds I were taken state a side effect of edema. Advil does this to me and so does Amoxicillan.
Erik
I do everything right and still have CAD.
I don't drink, I'm not 40 lbs over weight and I would never eat at MacDonalds.
Consider yourself lucky.....for now. This is a wake up call.
Alcohol is a poison. You are already overweight, so the carbs and calories in beer are bad, along with the sodium and saturated fat in fast food slop.
Please get smart, for your own sake.
Be well.
Erik
This is similar to Norvasc. I think that once your get up in the high dosages you are going to have this problem, especially if you drink and are overweight. I know that I was fine until I exceded the maximum daily recommended dosage.
Well spring is here and I am getting out of my funk, cleaning house, eating better, and hope to get out and do more exercise and lose a little weight.
That HDL is a problem. That's where mine typically was - guaranteed M.I. by the time your 50 if you also have high LDL, but I guess that you don't. It's been in the 50's for the last three years with Niaspan. That new Phizer drug should be better. If you live near Ohio you could probably get in the study. I think that I remember you saying you were from NY State.
Why do they want to take you off Zocor? Liver problems? With those numbers you probalby could just take Niaspan for HDL. Have you considered Welchol or Zetia? I've been taking Welchol since it came out -- haven't noticed any side effects.
It is pretty amazing to me that I have three vessel CAD with a totally occluded RCA and live a pretty normal life. It's also amazing that when I started feeling so good that I really started abusing myself with food and drink and still feel reasonably well physically. But I guess it's like a large ship, that takes a couple of years to turn - by the time you see the iceberg, it's too late!
Take care