Is leg pain a symptom of a heart attack?

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A heart attack is medically known as a myocardial infarction (MI). A heart attack occurs when a portion of the heart muscle becomes deprived of oxygen-rich blood.

This typically happens due to a blockage in one of the coronary arteries, which supply blood to the heart.

Experts do not consider leg pain a typical symptom of a heart attack. However, leg pain can be a symptom of other heart conditions.

Symptoms of a heart attack include:

• chest discomfort or pain
• chest pressure
• pain in the arms
• jaw and neck pain
• back pain
• abdominal pain
• nausea
• shortness of breath
• cold sweat
• lightheadedness

Leg pain related to heart conditions often arises due to issues with blood circulation.

Conditions such as peripheral arterial disease, blood clots, and certain congenital heart defects can reduce blood flow to the legs.

Peripheral arterial disease (PAD)

PAD is a circulatory condition that occurs when there is a narrowing or blockage in the arteries that supply blood to the extremities, primarily the legs.

This constriction is due to a buildup of plaque deposits within the arterial walls, a condition known as atherosclerosis.

Lack of blood flow to the legs may cause symptoms such as:

• pain or aching in the legs
• heaviness in the legs
• loss of leg hair
• pale, blue, or discolored legs or feet
• leg numbness or weakness
• pins and needles feeling in legs or feet
• foot wounds that are slow healing or do not heal

Congenital heart defect (CHD)

CHDs are structural abnormalities within the heart present from birth. They can disrupt normal blood.

CHDs are the most common birth defect. They affect approximately 1% of live births in the United States.

There are several types of CHDs. Most of them affect the interior walls, valves, and major blood vessels connected to the heart.

Symptoms associated with a CHD depend on several factors, including the person’s age, the defect type, and its severity.

Common symptoms include:

• bluish tint to the skin and lips
• constant fatigue
• heart murmurs
• poor blood circulation
• rapid breathing
• shortness of breath during physical exertion

According to a small 2018 survey, leg pain is a common symptom among children with CHD.

Venous thrombosis embolism (VTE)

VTE is when a blood clot develops in a vein. A common location for VTEs is the lower leg, thigh, or pelvis.

VTEs are a common condition. People have a higher risk of a VTE after surgery, a major injury, or during inflammation or infection.

Symptoms of VTE include:

• swelling in the legs
• pain or tenderness in the legs
• redness of the calf or thigh
• warm skin in the calf or thigh

Congestive heart failure (CHF)

CHF is a complicated condition in which the heart cannot adequately pump blood around the body.

CHF occurs due to conditions that weaken the heart muscle, reducing its ability to pump blood effectively. Factors such as coronary artery disease, high blood pressure, and heart valve disorders may contribute to CHF.

Symptoms of CHF include:

• shortness of breath or wheezing
• swelling in the ankles and lower legs
• chest pain
• loss of appetite
• fatigue
• heavy feeling in the legs
• leg tenderness

To diagnose whether a heart condition is causing leg pain, a doctor typically begins with a thorough medical history and physical examination to assess symptoms, risk factors, and overall health.

Diagnostic tests, such as ankle-brachial index (ABI) measurements, which assess blood pressure in the arms and legs, can help gauge blood flow and identify potential blockages.

Imaging tests may help a doctor visualize blood vessels and detect any abnormalities that could contribute to both leg pain and underlying heart conditions. These imaging tests include:

• Doppler ultrasound
• CT angiography
• magnetic resonance angiography (MRA)

Treatment strategies for heart conditions that may cause leg pain depend on the specific condition.

For PAD, lifestyle modifications, such as adopting a heart-healthy diet, exercising regularly, and quitting smoking, are crucial to improving blood circulation.

Medications, including blood thinners and cholesterol-lowering drugs, can help manage the risk factors contributing to PAD.

VTEs often require anticoagulant medications to prevent clot growth and recurrence.

CHDs may need procedures or surgery to repair the defect. In severe cases, a person may require a heart transplant.

CHF treatments aim to improve heart function and manage fluid retention with medications, lifestyle adjustments, and, in severe cases, interventions such as implantable devices or a heart transplant.

If a person is experiencing leg pain that they suspect could be related to a heart condition, it is important to seek medical attention, especially if they notice any of the following:

• severe or sudden leg pain
• persistent pain
• changes in leg color or temperature
• swelling (edema)

Leg pain is typically not a direct symptom of a heart attack. Instead, heart attacks are commonly associated with chest discomfort, shortness of breath, and pain radiating to the arms, neck, or back.

However, leg pain can result from cardiovascular conditions that affect circulation, such as peripheral arterial disease, congenital heart defects, venous thromboembolism, and congestive heart failure.

Recognizing atypical symptoms and understanding the links between leg pain and cardiac conditions are crucial for timely diagnosis and appropriate medical attention.