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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Swelling In The Lower Legs?

Hi Doc,
My mother has come home ( it's about 4 weeks now) after Aortic valve replacement. She is on one tablet of 40 mg Lasix daily, she has been going for walks for the past 10 days. However, her lower legs, particularly her ankles and feet has swelling - like a water pillow. How soon will her feet get back to normal?

- Thank you
Nandini
Mon, 28 Sep 2015
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Cardiologist 's  Response
Greetings! Welcome to HCM and thank your for your question. I understand your concern.

Well, if there are not any other diseases, especially kidney disease, then this clinical sign is produced by an enlarged heart, probably because of a long-standing suffering from aortic valve disease. If this phenomenon is still present, and also is the left ventricle enlargement, then it is recommended an echo cardiogram to be obtained one month after the surgery. New valve and other valve functions have to be assess, also the function of the left ventricle, its size and motility, after the valvular replacement. The dosage of furosemide, and route of administration (intravenous or orally) should be decided in function of leg swelling and other clinical signs of increased systemic pressures, caused by an enlarged heart. If intravenous route of administration is warranted, to abolish this symptom, then hospitalization for a few days is required. If no shortness of breath is present, then you could simply try to double the dosage of furosemide, and see the results. Also, large amount of time spent on standing or sitting up position should be avoided, because of the fluid pooling in the lower limbs due to simple phenomenon of gravity, and salt should be reduced to minimal levels on her diet.

I hope I was helpful.

Best regards,
Dr. Meriton
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What Causes Swelling In The Lower Legs?

Greetings! Welcome to HCM and thank your for your question. I understand your concern. Well, if there are not any other diseases, especially kidney disease, then this clinical sign is produced by an enlarged heart, probably because of a long-standing suffering from aortic valve disease. If this phenomenon is still present, and also is the left ventricle enlargement, then it is recommended an echo cardiogram to be obtained one month after the surgery. New valve and other valve functions have to be assess, also the function of the left ventricle, its size and motility, after the valvular replacement. The dosage of furosemide, and route of administration (intravenous or orally) should be decided in function of leg swelling and other clinical signs of increased systemic pressures, caused by an enlarged heart. If intravenous route of administration is warranted, to abolish this symptom, then hospitalization for a few days is required. If no shortness of breath is present, then you could simply try to double the dosage of furosemide, and see the results. Also, large amount of time spent on standing or sitting up position should be avoided, because of the fluid pooling in the lower limbs due to simple phenomenon of gravity, and salt should be reduced to minimal levels on her diet. I hope I was helpful. Best regards, Dr. Meriton