The heart failure
Swollen ankles are a common symptom of heart failure. They are caused by the reduced pumping capacity of the heart, which causes an accumulation of the circulating blood volume in front of the heart. If the congestion is very severe, fluid is “squeezed” out of the vessels into the surrounding tissue.
Clinically, affected patients then notice the accumulation of fluid as swelling (Latin: edema). The fact that the ankles in particular are affected by swelling is due to pure gravity. When standing, it is highest in the legs. The symptoms of heart failure?
The protein deficiency edema
A protein deficiency edema can also be the cause of swollen ankles, although it does not typically cause this symptom. A typical symptom is a “bloated” abdomen, which develops as a reaction to the protein deficiency. In the absence of albumin, it cannot fulfil its function of keeping the fluid in the blood vessels.
As a result, fluid leaks into surrounding structures. Since there are many vessels in the abdominal area, this is where the fluid leakage is highest and a deceptively round, bulging abdomen is formed. Nevertheless, oedema also occurs in the ankle area, but is much less pronounced in comparison.
The varicose veins
Varicose veins are defined as dilated vessels that are no longer able to transport enough blood to the heart due to their pathologically altered valves. Strictly speaking, the closing mechanism in these dilated vessels no longer functions, so that the blood sinks back down towards the feet along the force of gravity. The larger the filling volume of the varicose veins becomes, the more the vessel wall becomes leaky and more fluid is pressed into the surrounding tissue. Those affected notice this by swelling of the ankles and sometimes even the lower legs. You can find more information under: The varicose veins.
The medicines
Medication can cause swollen ankles as a side effect. Blood pressure medications and hormone preparations are particularly known for this side effect. In the case of blood pressure medications, it is mainly calcium antagonists such as amlodipine, for example, that cause the vessels to dilate in order to lower blood pressure.The hormone preparations are mainly drugs with an estrogen content, which are used, for example, as part of a hormone replacement therapy during menopause or in various anti-baby pills. In general, however, if ankle swelling occurs in connection with a new medication, the patient should read the package insert and inform the treating physician.
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