Medical history (history of illness) represents an important component in the diagnosis of leg swelling (“leg edema”). Travel history
- Recording of travel duration and foreign travel, here primarily from tropical stays, furthermore, any infections that may have occurred.
Family history
- Is there a history of heart disease in your family? Kidney disease? Liver disease? Lung diseases? Thyroid disease?
Social history
- Do you have a job that requires you to stand or sit for long periods of time?
- Have you taken a long-haul flight recently?
Current medical history/systemic history (somatic and psychological complaints).
- When did the swelling first occur?
- Is the leg swelling unilateral or bilateral?
- Did the swelling occur suddenly or gradually?
- When does the swelling occur?
- Permanent?
- After standing or sitting for a long time?
- In the evening?
- Cycle dependent?
- Do you have a feeling of tightness in the swollen areas of your body?
- Do you have any pain in your leg? *
- Onset of pain (e.g., sudden strain on calf muscles → muscle fiber tear?)?
- In addition, is the leg overheated? *
- Do the symptoms such as pain and swelling change after lying down and at night? If so, in what way?
- Do you have palpitations? *
- Do you have cold sweats, are you pale, and do you have a drop in blood pressure? *
- Do you experience shortness of breath on exertion or at rest? *
- Do you have a fever? Chills?
- Do you have a knee joint effusion?
- Do you have any other complaints such as:
- Bluish skin color?
- Cold skin?
- Cold and bluish discolored lips and fingers?
- Areal redness of the skin?
- Atrophic skin changes (loss of skin elasticity)?
- Dry, itchy skin?
- Decrease in performance?
- Increased urination at night?
- Cough at night?
- Stomach discomfort?
- Loss of appetite?
Vegetative anamnesis including nutritional anamnesis.
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Has your body weight changed unintentionally?
- Do you get enough exercise every day?
- Do you drink enough?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses of it per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
Self-history
- Pre-existing conditions (metabolic diseases (e.g., diabetes mellitus, thyroid dysfunction), cardiovascular diseases (e.g., venous disease, deep vein thrombosis; peripheral arterial occlusive disease, hypertension/high blood pressure), renal disease, liver disease, lung disease, thyroid disease, tumor disease, eating disorders; accident).
- Operations
- Allergies
- Pregnancies
- Radiatio (radiotherapy)
- Environmental history
Medication history
- ACE inhibitors (angioneurotic edema; incidence (frequency of new cases): approximately 1%; mortality (death rate): 1%) – benazepril, captopril, cilazapril, enalapril, fosinopril, lisinopril, moexipril, peridopril, quinapril, ramipril, spirapril
- Analgesics
- Non-steroidal anti-inflammatory drugs (NSAIDs, non-steroidal (acetylsalicylic acid (ASA), diclofenac, indometacin, ibuprofen, meloxicam, piroxicam) – lead to increased fluid retention in the feet and ankles, among other things.
- Selective COX-2 inhibitors (coxibe) – celecoxib, etoricoxib.
- Antidepressants (amitriptyline* /in patients > 70 years of age).
- Antihypertensives – especially dihydropyridine-type/nifedipine-type calcium antagonists; second- and third-generation such as lercanidipine are better tolerated
- Typical: ankle edema – increases during the day and regresses overnight
- Antipsychotics (neuroleptics).
- Chlorpromazine* , clozapine* , haloperidol* , thioridazine* .
- Diuretics* – especially loop diuretics such as furosemide and torasemide, which can cause leg edema [exsiccosis].
- Glitazones
- Typical: peripheral edema
- Hormones (lead, among other things, to increased fluid retention in the area of the feet and ankles).
- Androgens (testosterone, testosterone antate, testosterone undecaonate).
- Progestogens* (etonogestrel, desogestrel, dienogest, levonorgestrel, medroxyprogesterone acetate, medrogestone, norelgestromin, norethisterone).
- Glucocorticoids* (budenoside, cortisone, fluticasone, prednisolone).
- Estrogens* (ethinyl estradiol, estradiol) – estrogen therapy as hormone replacement therapy (HT): increase in thromboembolic risk by: + 6 events per 10,000 women per year of use.
- Estrogen-progestin combinations* (oral contraceptives: ethinyl estradiol + norethisterone / norgestrel derivative – especially in combination with smoking; hormone replacement therapy, HRT; English : hormone replacement therapy / HRT) in menopause: increase in thromboembolic risk by: + 17 events per 10,000 women per year of use.
- Growth hormone (somatotropic hormone (STH), human growth hormone (hGH), growth hormone (GH), growth hormone (WH), somatropin (INN)).
- Laxatives – when taken for prolonged and uncontrolled periods, they disrupt water and electrolyte balance as well as protein and mineral concentrations, impairing the removal of fluid from tissues
- Psychotropic drugs – atypical neuroleptics, lithium, MAO inhibitors, tricyclic antidepressants.
* Thrombosis/embolism due to medication.
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)