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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 55189
Experience:  Cardiology Expert
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I am a 27 year old obese female and I have had pitting edema

Customer Question

I am a 27 year old obese female and I have had pitting edema in my shins and ankles for aboit two years.
I have brought this up to my doctor on a few occasions, but she does not seem worried, saying that I likely eat too much salt and have poor veins. My mother also has this problem and she is in her 60s.
Another relative though, told me that this means that I have congestive heart failure.
This doesn't sound right to me as I hike and walk everywhere with out getting short of breath or anything.
Still, she kind of freaked me out. Is whAt she is saying true?
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 1 year ago.

did he test your heart?

do you take any meds?

are you overweight?

Customer: replied 1 year ago.
They did an ekg, took my pulse and stuff and it was all fine.She prescribed me a mild diuretic.I am overweight.
Expert:  Dr. Phil, MD replied 1 year ago.

Okay. An easy way to be sure is with a BNP blood test. This is a very good marker of heart failure. Just ask for this. If this is normal then it is likely the weight that is causing this combined with veins not working great in the legs.

Also, heat makes it worse because heat causes dilation of blood vessels. This then leaks fluid into the tissues in the legs.

I recommend weight loss, low salt, compression socks and leg elevation if the BNP is normal

Customer: replied 1 year ago.
Is that the test where they check your kidney and liver function?If so that was already done and came back normal.
Expert:  Dr. Phil, MD replied 1 year ago.

No that is a CMP or BMP.

YOu need a heart specific BNP

Expert:  Dr. Phil, MD replied 1 year ago.

Please don't forget a positive rating. If you have more questions, just reply

Expert:  Dr .Saeed ahmed replied 1 year ago.

I disagree with Dr phil opinion, If you have swelling of the feet then first things to know is it present in both legs ? does it forms a pit when pressed ? If yes then you need to rule out 4 important possibilities.. these are 1..heart failure. 2... nephrotic syndrome.3.... malabsorption and varicose veins. Stepwise approach includes blood test for protein levels, urine for protein leakage, echocardiogram and doppler scan of the legs. With help of these test we can make sure of accurate cause. BNP levels which Dr phil have mentioned has less value in overweight and it has only negative predictive value, which means if this is positive then you cannot say it is due to heart failure and still you need to go for echocardiogram. So BNP levels have limitation in this case and should not be used as first test.

I hope this answers your question. Let me know if you need more assistance.

Expert:  Dr .Saeed ahmed replied 1 year ago.

While on other hand if swelling is on one leg only then we need to rule out clot, infection and inflammation in that leg. Also if the edema does not forms a pit when pressed then it can be due to blockage of the lymphatic ducts.

Expert:  Dr. Phil, MD replied 1 year ago.

This is an extreme workup for a simple problem.

Please see my reply for a very efficient cost effective workup

Expert:  Dr. Phil, MD replied 1 year ago.

please don't forget a positive rating. I appreciate it.

If you have more questions, just reply :)