Heart failure can cause swelling in the feet and other parts of the body, such as the abdomen. The swelling may come and go, but it often lasts for long periods. When swelling is in one foot, occurs just once, and does not recur, it may have another cause, such as an injury.

Heart failure causes fluid retention in the body, and this can lead to several conditions, including edema. Edema refers to swelling as a result of excess fluid, and it can affect various parts of the body, including the ankles and feet.

As many conditions or circumstances, including pregnancy, can cause swelling in the feet, it is important to see a doctor rather than try to self-diagnose.

In this article, we describe the signs and symptoms of heart failure that a person might experience alongside swollen feet. We also provide information on treatment, when a person should contact a doctor, and the other possible causes of swollen feet.

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Heart failure is when the heart has more difficulty pumping blood through the body, leading to fluid accumulation elsewhere in the body, especially in the feet and legs.

A person may experience the following issues:

  • feet suddenly looking larger or puffy
  • shoes are not fitting as well as usual
  • pain in their feet or legs
  • more difficulty walking
  • swelling elsewhere in their body, such as the abdomen
  • unexplained weight gain

Swelling in the feet and ankles may be less severe when a person first wakes and worsen as their day goes on.

Some other symptoms of heart failure that a person might notice include:

  • getting easily winded
  • finding exercise difficult
  • unexplained fatigue or weakness, even if a person is well-rested
  • pain in the right upper stomach, under the ribs
  • heart palpitations
  • difficulty breathing while lying flat

Heart failure is a life threatening medical condition that a person cannot treat with home remedies or lifestyle changes alone. Most people require the ongoing support of a cardiologist and some may need to take heart medication for the rest of their lives.

Lifestyle adjustments

For people living with heart failure, behavioral changes can make a significant difference in their quality of life. A person can adopt the following measures:

  • Reducing the amount of salt in the diet: High-sodium foods include prepackaged, fried, and processed foods, such as prepared meals and potato chips. The body needs some sodium to function, so it is important to not eliminate it from the diet. Instead, people should limit their sodium intake to less than 2,300 milligrams per day.
  • Increasing, or maintaining, physical activity levels, where possible: A doctor should be able to provide advice on how to create and stick to a healthy exercise routine. Exercise can help the heart function more efficiently, and it may also address other risk factors, such as excess body weight and high blood pressure.
  • Managing stress, where possible: People can practice stress management techniques, such as meditation, therapy, or journaling. People with heart failure may find that their symptoms get worse during emotional crises.
  • Alcohol and tobacco: People should avoid or quit smoking and limit or avoid their intake of alcohol.

Learn how to follow a heart-healthy diet here.

It is also important for a person to monitor their symptoms. A doctor may recommend at-home blood pressure monitoring or regular heart health checkups.

People can check their own blood pressure at home. Learn how to do this here.

Medical treatment

There is no cure for heart failure, but treatment can greatly prolong a person’s life and reduce their symptoms. A doctor may recommend the following treatments:

  • Medication: A combination of medications can help, including beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and sodium-glucose cotransporter-2 (SGLT-2) Inhibitors, among others. The right drugs for a person will depend on their type of heart failure, lifestyle, and other medical conditions.
  • Implantable devices: Various devices can help the heart work better. A left ventricular assist device, for example, can help the left ventricle work better and reduce the overall effort of the heart. It can be a good option for a person who is waiting for a heart transplant.
  • Implantable cardioverter defibrillators (ICDs): A doctor may recommend an ICD in certain people with heart failure to reduce their risk of sudden cardiac death. It will not help the heart work better, however.
  • Heart transplant: Some people with heart failure, especially those with severe heart failure, who have a good chance of survival with treatment, may need a heart transplant.
  • Cardiac interventions and surgery: In some cases of heart failure, surgery may help. A cardiologist may perform various procedures, such as cardiac catheterization or coronary artery bypass surgery.
  • Fluid restrictions: In people with heart failure who retain fluid, a doctor may recommend restricting their fluid and salt intake. Sometimes doctors prescribe diuretics, or “water pills,” to help a person get rid of excess fluid and help keep their fluids balanced.

People who notice unusual swelling in their feet should always call a doctor. A person should also speak with a doctor if they:

  • know they have heart failure and notice new or worsening swelling
  • have a high fever or feel shivery
  • have swelling on just one side of the body
  • have swelling in one or both feet or ankles for no obvious reason
  • experience painful, severe, and sudden swelling
  • have symptoms that are not responding to home treatment
  • have swelling along with other symptoms, such as difficulty breathing
  • develop painful or unpleasant side effects after they start taking a medication
  • suddenly gain weight for no apparent reason
  • have diabetes and their legs or ankles have swollen
  • have a swollen area that is red and feels hot to the touch

Numerous other conditions can cause swelling in the feet, including:

  • Pregnancy: Swollen feet during pregnancy are very common due to increased blood volume.
  • Blood clots: A blood clot in the veins of the leg may cause swelling in one foot.
  • Organ failure: Problems with other organs, such as the liver or kidneys, may cause swelling. Organ failure may also eventually affect the heart.
  • Long periods of standing or sitting: Long periods of physical activity or standing may cause swelling that goes down when a person rests. Likewise, sitting for long periods, such as when flying, can also cause swelling that improves with movement. Sometimes, this swelling is worse in the heat. Instead of standing, sitting with the feet raised or walking around can help.
  • Injuries: Injuries to the feet or legs can cause inflammation and swelling. In most cases, the swelling will be in just one foot.
  • Venous insufficiency: In this condition, the veins in the legs do not function properly, potentially leading to a buildup of blood in the feet.
  • Lymphedema: Lymphedema occurs when damage to the lymph system leads to the accumulation of fluids.
  • Infection: Cellulitis, a skin and soft tissue infection, can affect the feet and cause swelling.

Learn whether certain causes of swelling are serious here.

The following images show how swollen feet can look due to heart failure and other causes.

Here are some questions people often ask about swollen feet and heart failure.

How do you get rid of swollen feet from heart failure?

It is essential to follow the treatment plan for heart failure to help manage symptoms. A doctor may also recommend diuretics to help eliminate some fluid from the body. Other tips include raising the feet when sitting, minimizing salt intake, avoiding tight footwear, getting some gentle exercise, and speaking with a doctor about how much water to drink.

At what stage of heart failure does edema happen?

Swollen feet can happen at any stage of heart failure, but worsening edema may mean that heart failure is becoming more severe.

Do swollen feet mean heart failure?

Swollen feet can be a sign of heart failure. When the heart is unable to pump blood around the body effectively, it pools in the lower extremities. However, swelling in the feet can happen for many reasons, such as kidney failure, lymphedema, a blood clot, an injury, or an infection, such as cellulitis.

When should I worry about swollen feet?

People should see a doctor if there is new or persistent swelling, or if their symptoms are severe. They should also seek medical help if they have a fever or other symptoms or if the swollen area feels red or hot to the touch.

Swollen feet do not always mean that a person has a serious medical condition. However, it can be an important early warning sign of heart disease or other health issues, particularly if it persists, recurs, or occurs alongside other symptoms.

Anyone with any concerns about swollen feet or other symptoms of heart failure should speak with a doctor as soon as possible.

Read this article in Spanish.