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What Causes Swelling In Ankle, Dizziness And Profuse Sweating In A Person With Low BP?
Question: Hello,
I was advised by an emt that when he checked my heart rate and listened to my chest I was experiencing A-fib.
I have been dealing with a lot of stress, I also have been experiencing some significant swelling in my left ankle- sometimes up to my knee. I was told that that was most likely lymph edema (by an ER Dr.), but researching lymph edema I am lost because everything I see on the subject stipulates it's due to injury caused to the lymph glands, often from biopsy. I've had no biopsy that I know of.
I also have very low blood pressure. It is not unusual for me to have a reading of 93/60, or 100/68. My temperature is usually around 96.5-ish. I definitely get cold easily, and I hate the winter. Once I'm cold, I stay cold for quite a while.
I get light headed fairly often, and I get winded, too.
When I'm trying to function harder than I feel up to, I'll sweat profusely and my nose will run, and I'll be tired and feel scared.
I've always been sensitive to heat, when I was young my sister and I would take baths together. She loved hot water, but it would make me nauseous. Sometimes I'd vomit. To this day, I cannot take very hot baths or showers or I'll be ill.
I had a hysterectomy and bilateral oophorectomy at 29. I do not take hormones.
I have listened to my heart a few times, just to see. What I hear is that my heart seems to kinda slow down, miss a beat, sorta, or hiccup, or seemingly stop, then THUD...beat beat.
I've had a couple of weird episodes where I felt more than just faint. I felt very weak. I have a home electronic bp monitor, and I can't remember the reading, but I remember the top number was 72 one time. Ran it again, same. I remember that much.
Washing my hair is difficult because my arms get so tired that I start to get faint a little and my heart will speed up some.
Where could the lymph edema have come from, do you think?
Does what I described sound like A-fib?
Thank you.
I was advised by an emt that when he checked my heart rate and listened to my chest I was experiencing A-fib.
I have been dealing with a lot of stress, I also have been experiencing some significant swelling in my left ankle- sometimes up to my knee. I was told that that was most likely lymph edema (by an ER Dr.), but researching lymph edema I am lost because everything I see on the subject stipulates it's due to injury caused to the lymph glands, often from biopsy. I've had no biopsy that I know of.
I also have very low blood pressure. It is not unusual for me to have a reading of 93/60, or 100/68. My temperature is usually around 96.5-ish. I definitely get cold easily, and I hate the winter. Once I'm cold, I stay cold for quite a while.
I get light headed fairly often, and I get winded, too.
When I'm trying to function harder than I feel up to, I'll sweat profusely and my nose will run, and I'll be tired and feel scared.
I've always been sensitive to heat, when I was young my sister and I would take baths together. She loved hot water, but it would make me nauseous. Sometimes I'd vomit. To this day, I cannot take very hot baths or showers or I'll be ill.
I had a hysterectomy and bilateral oophorectomy at 29. I do not take hormones.
I have listened to my heart a few times, just to see. What I hear is that my heart seems to kinda slow down, miss a beat, sorta, or hiccup, or seemingly stop, then THUD...beat beat.
I've had a couple of weird episodes where I felt more than just faint. I felt very weak. I have a home electronic bp monitor, and I can't remember the reading, but I remember the top number was 72 one time. Ran it again, same. I remember that much.
Washing my hair is difficult because my arms get so tired that I start to get faint a little and my heart will speed up some.
Where could the lymph edema have come from, do you think?
Does what I described sound like A-fib?
Thank you.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
I passed carefully through your medical history and would like to explain that your symptoms seem more likely to be connected with a premature menopause and its consequences after hysterectomy and bilateral oophorectomy.
Let me explain that your doubts about the possibility of lymph edema are right.
Lymph edema happens generally when there exists a disruption of the lymphatic drainage (any surgery, cancer, infection, radiation, etc, that could damage lymph nodes and block the appropriate lymph transit).
There are also some rare causes of primary lymph edema (lymphedema tarda, Milroy and Meige disease, etc), but it doesn't seem to be your case.
As you have been lacking the hormones produces in the ovaries, your body has suffered from their beneficial effects leading to adverse consequences like:
- depression and anxiety,
- heart disorders, like blood pressure instability, heart rhythm disorders, etc.
- extreme tiredness, weakness,
- unusual temperature intolerance and bad accommodation,
- limbs edema,
- decreased metabolism turnover,
- decreased sex drive, etc.
In addition, I would like to say that extrasystolic arrhythmia and even episodes of atrial fibrillation could not be excluded in your conditions.
To avoid such unpleasant phenomena, I recommend you to consider an immediate consult with your attending gynecologist and discuss the possibility of starting hormone replacing therapy for minimizing the consequences of their deficiency.
Also a comprehensive cardiology checkup comprising a careful physical exam, a resting ECG, chest X ray study, cardiac ultrasound, and if suspicions of atrial fibrillation persist also an ambulatory ECG monitoring (24 hours Holter) test would be helpful to definitely clarify your cardiac status.
Some lab tests like:
- complete blood count,
- renal function tests (BUN and creatinine)
- blood electrolyte levels,
- plasma protein levels,
- liver function tests,
- thyroid hormones (FT3, FT4, TSH)
- fasting blood glucose,
- blood lipid profile
would be helpful to explore potential metabolic implications of your actual clinical scenario.
I hope that the above recommended diagnostic work up strategy with be helpful in properly addressing your complaints.
In case of any further uncertainties don not hesitate to contact me.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
I passed carefully through your medical history and would like to explain that your symptoms seem more likely to be connected with a premature menopause and its consequences after hysterectomy and bilateral oophorectomy.
Let me explain that your doubts about the possibility of lymph edema are right.
Lymph edema happens generally when there exists a disruption of the lymphatic drainage (any surgery, cancer, infection, radiation, etc, that could damage lymph nodes and block the appropriate lymph transit).
There are also some rare causes of primary lymph edema (lymphedema tarda, Milroy and Meige disease, etc), but it doesn't seem to be your case.
As you have been lacking the hormones produces in the ovaries, your body has suffered from their beneficial effects leading to adverse consequences like:
- depression and anxiety,
- heart disorders, like blood pressure instability, heart rhythm disorders, etc.
- extreme tiredness, weakness,
- unusual temperature intolerance and bad accommodation,
- limbs edema,
- decreased metabolism turnover,
- decreased sex drive, etc.
In addition, I would like to say that extrasystolic arrhythmia and even episodes of atrial fibrillation could not be excluded in your conditions.
To avoid such unpleasant phenomena, I recommend you to consider an immediate consult with your attending gynecologist and discuss the possibility of starting hormone replacing therapy for minimizing the consequences of their deficiency.
Also a comprehensive cardiology checkup comprising a careful physical exam, a resting ECG, chest X ray study, cardiac ultrasound, and if suspicions of atrial fibrillation persist also an ambulatory ECG monitoring (24 hours Holter) test would be helpful to definitely clarify your cardiac status.
Some lab tests like:
- complete blood count,
- renal function tests (BUN and creatinine)
- blood electrolyte levels,
- plasma protein levels,
- liver function tests,
- thyroid hormones (FT3, FT4, TSH)
- fasting blood glucose,
- blood lipid profile
would be helpful to explore potential metabolic implications of your actual clinical scenario.
I hope that the above recommended diagnostic work up strategy with be helpful in properly addressing your complaints.
In case of any further uncertainties don not hesitate to contact me.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your help in this matter.
As I do recognize you are a doctor, and I am just me...trying to find answers, but certainly not at all as well versed as you on these issues, the research I've done on HRT being started so long after a lack of hormones is that the general medical consensus leans itself toward a negative attitude on this option. I've been without those hormones since age 29, and I am 48 now. This stuff (latest medical knowledge base) does seem to change frequently, though, and I am sure I am not reiterating the newest news.
But, of the latest data available to a layperson like myself, it is said there is not as much benefit as should be once a significant period of time has passed without hormones when one attempts to re-establish hrt.
Other research studies available to me state that my life will be shortened significantly because of the medically/surgically induced menopause, and that I stand to develop dementia not quite certainly, but that this is more a probability than not.
Yes, depression is very fitting of how I currently feel. Like things are hopeless. I read some articles that gave me pause about my low blood pressure. I'd always been happy regarding not having high blood pressure -- until I read the articles that made reference to a higher risk of blood clots and stroke not just in people with A-fib, but an even more elevated risk in someone with low blood pressure AND A-fib together.
I do not have a gynecologist. I am not very good in the physical presence of Drs of any sort. People of any sort tend to bring about much anxiety for me (it's my problem, not in any way intentionally caused by others--I needed to clarify that) But I can certainly try to look into making a follow up with some sort of Dr. Although I can already feel my throat tighten a bit just thinking about that.
And, please forgive me on this question if it seems stupid: You said my doubts about the lymph edema might be accurate (I'm paraphrasing), but you listed limb edema as one of the complications of early menopause. Could you help me understand limb edema, please? Someone told me a while back that the left leg isolatedly experiencing swelling and fluid retention is a common sign of heart failure. This person was not a Dr. But rather someone who spends a fair amount of time with people with fairly major health challenges (diabetes, heart issues, renal failure, etc).
The possibility of that being a reality for my near future weighs heavily on my spirit.
If there is one type of Dr. more than another that would be the most effective for me to see, which type would you recommend? Perhaps a gp for a referral to ...a cardiac specialist? or should I pursue a new contact with a new gynecologist even though they have absolutely no reason to poke or probe me?
Thank you for your time and patience.
As I do recognize you are a doctor, and I am just me...trying to find answers, but certainly not at all as well versed as you on these issues, the research I've done on HRT being started so long after a lack of hormones is that the general medical consensus leans itself toward a negative attitude on this option. I've been without those hormones since age 29, and I am 48 now. This stuff (latest medical knowledge base) does seem to change frequently, though, and I am sure I am not reiterating the newest news.
But, of the latest data available to a layperson like myself, it is said there is not as much benefit as should be once a significant period of time has passed without hormones when one attempts to re-establish hrt.
Other research studies available to me state that my life will be shortened significantly because of the medically/surgically induced menopause, and that I stand to develop dementia not quite certainly, but that this is more a probability than not.
Yes, depression is very fitting of how I currently feel. Like things are hopeless. I read some articles that gave me pause about my low blood pressure. I'd always been happy regarding not having high blood pressure -- until I read the articles that made reference to a higher risk of blood clots and stroke not just in people with A-fib, but an even more elevated risk in someone with low blood pressure AND A-fib together.
I do not have a gynecologist. I am not very good in the physical presence of Drs of any sort. People of any sort tend to bring about much anxiety for me (it's my problem, not in any way intentionally caused by others--I needed to clarify that) But I can certainly try to look into making a follow up with some sort of Dr. Although I can already feel my throat tighten a bit just thinking about that.
And, please forgive me on this question if it seems stupid: You said my doubts about the lymph edema might be accurate (I'm paraphrasing), but you listed limb edema as one of the complications of early menopause. Could you help me understand limb edema, please? Someone told me a while back that the left leg isolatedly experiencing swelling and fluid retention is a common sign of heart failure. This person was not a Dr. But rather someone who spends a fair amount of time with people with fairly major health challenges (diabetes, heart issues, renal failure, etc).
The possibility of that being a reality for my near future weighs heavily on my spirit.
If there is one type of Dr. more than another that would be the most effective for me to see, which type would you recommend? Perhaps a gp for a referral to ...a cardiac specialist? or should I pursue a new contact with a new gynecologist even though they have absolutely no reason to poke or probe me?
Thank you for your time and patience.
Brief Answer:
Directly contacting a doctor could result in an efficient interaction.
Detailed Answer:
Hi again,
First I would like to let you know, I am glad to discuss with a smart person apt to medical knowledge.
You are right that HRT poses increased risks (cardiovascular, breast cancer, etc.) especially in naturally post-menopausal women.
But, I am not suggesting you exactly that.
Almost all the already studies performed in that field (screening for beneficial and associated dangerous effects as well) are performed in women who were in their sixties and seventies and who had undergone menopause naturally.
Most experts agree, in general, that young women (entering for non-natural reasons in premature menopause) should use hormone therapy at least until they turn 50 years.
As you are yet a young and active woman, probably slow to moderate degrees of lacking hormones could yield regression of those adverse symptoms without producing complications.
You need to discuss with a gynecologist.
Probably maximal effects could be drawn if therapy would be started early especially in regards of osteoporosis and trophic disorders prevention. But again there is place for a possible improvement.
Regarding your limbs edema, I could explain that unilateral edema may be due to local veins insufficiency, as well as heart failure, renal disease, thyroid dysfunction, etc.
Premature menopause by interfering with blood vessels trophic condition, overall cardiovascular functioning, circulating fluid homeostasis (arginine-vasopressin regulation, mineralocorticoid effects, etc.) could trigger fluid retention (and resulting edema) prejudiced by underlying disorders.
But, we can’t speculate on that matter without sufficient medical evidence.
That’s why I recommended you to follow the above mentioned diagnostic work up.
Of course, you need to discuss with your attending doctor (internist or GP) so he could refer you for a careful check up by your cardiologist.
As a cardiologist, I would strongly recommend you a careful cardiovascular checkup.
You shouldn’t be anxious by directly discussing with a doctor, as it could result in a friendly and efficient interaction.
If you have medical reports after you perform any medical tests, I would be glad to review them for a second opinion. You could upload them here.
Please let me know how things are going on.
Best wishes,
Dr. Iliri
Directly contacting a doctor could result in an efficient interaction.
Detailed Answer:
Hi again,
First I would like to let you know, I am glad to discuss with a smart person apt to medical knowledge.
You are right that HRT poses increased risks (cardiovascular, breast cancer, etc.) especially in naturally post-menopausal women.
But, I am not suggesting you exactly that.
Almost all the already studies performed in that field (screening for beneficial and associated dangerous effects as well) are performed in women who were in their sixties and seventies and who had undergone menopause naturally.
Most experts agree, in general, that young women (entering for non-natural reasons in premature menopause) should use hormone therapy at least until they turn 50 years.
As you are yet a young and active woman, probably slow to moderate degrees of lacking hormones could yield regression of those adverse symptoms without producing complications.
You need to discuss with a gynecologist.
Probably maximal effects could be drawn if therapy would be started early especially in regards of osteoporosis and trophic disorders prevention. But again there is place for a possible improvement.
Regarding your limbs edema, I could explain that unilateral edema may be due to local veins insufficiency, as well as heart failure, renal disease, thyroid dysfunction, etc.
Premature menopause by interfering with blood vessels trophic condition, overall cardiovascular functioning, circulating fluid homeostasis (arginine-vasopressin regulation, mineralocorticoid effects, etc.) could trigger fluid retention (and resulting edema) prejudiced by underlying disorders.
But, we can’t speculate on that matter without sufficient medical evidence.
That’s why I recommended you to follow the above mentioned diagnostic work up.
Of course, you need to discuss with your attending doctor (internist or GP) so he could refer you for a careful check up by your cardiologist.
As a cardiologist, I would strongly recommend you a careful cardiovascular checkup.
You shouldn’t be anxious by directly discussing with a doctor, as it could result in a friendly and efficient interaction.
If you have medical reports after you perform any medical tests, I would be glad to review them for a second opinion. You could upload them here.
Please let me know how things are going on.
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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