Heart failure is one of the more serious conditions that can cause edema. Treatment options can depend on the severity.

Edema is the clinical term for swelling due to fluid retention. It can result from injuries, illnesses, or health conditions.

Heart failure can cause edema if:

  • the heart muscle weakens and can no longer pump enough blood to meet the body’s needs
  • high blood pressure causes fluid to back up into the legs or abdomen
  • a leaky heart valve causes fluid retention

Treating heart failure can help relieve edema and other symptoms. In this article, we’ll cover why heart failure causes edema and current treatment options.

It’s possible to have edema without heart failure. If you notice unusual swelling, particularly in your legs and feet, it’s always best to talk with a medical professional as soon as possible.

Was this helpful?

If you have heart failure, your heart isn’t able to pump enough blood out through the arteries and bring it back through the veins. Without medications or devices to improve the strength of the heart muscle, this can cause blood to pool, especially in your legs and feet.

Your veins require a certain amount of force from your heart to keep blood flowing up to the heart and lungs, where it receives oxygen and other nutrients. The pressure inside the veins is also higher due to higher pressures in people with heart failure.

If blood doesn’t circulate properly, excess blood and other fluids in the capillaries can leak out into bodily tissues, causing edema.

Sometimes edema is the first sign of heart failure. Once heart failure is diagnosed, it becomes important to monitor increases in body weight that may result from increased fluid retention.

A 2021 review of research suggests that increases in edema may also predict worsening heart failure.

What does heart failure mean?

The term heart failure means the heart has grown weaker or stiffer. It still pumps blood, but not enough to meet the body’s needs. Heart failure can result from several issues, including:

Other health conditions like diabetes and sleep apnea can also indirectly weaken the heart.

Was this helpful?

Types of edema that may be the result of heart failure include:

  • Pedal edema: This type involves swelling in the feet and legs and is a common early sign of heart failure.
  • Peripheral edema: Peripheral edema involves swelling of the hands or lower legs.
  • Pitting edema: This type of edema involves swelling in the feet, legs, or anywhere else. Pitting edema leaves a “pit” or dent in the skin on the affected area.
  • Pulmonary edema: This type refers to a buildup of fluid in the lungs.

Edema can also result from other causes. These range from temporary and harmless to serious and chronic conditions that require ongoing medical care.

Other causes of edema

Other common causes of edema include:

  • Sitting or lying down in one position for too long: Simply getting up and moving around usually alleviates swelling in the legs and feet.
  • Menstruation and pregnancy: Both can lead to temporary fluid retention and swollen feet and legs.
  • Eating a lot of salty foods: Consuming excess sodium causes the body to retain more fluid to help keep sodium levels from getting too high. The additional sodium is excreted in urine.
  • Venous insufficiency: If you have problems with the veins that keep them from moving blood along its path to the heart, it allows fluid to leak into nearby tissue.
  • Kidney disease: When the kidneys don’t remove enough fluid and sodium, pressure inside blood vessels increases and can result in edema. Kidney-related edema may affect the legs or face.
  • Lung disease: Serious lung conditions, like emphysema, can lead to lower leg edema when the right side of the heart starts to fail.
  • Liver disease (cirrhosis): Cirrhosis can prevent blood from passing through the liver properly. This increases pressure in the vein that brings blood to the liver from the intestines and spleen, causing fluid to accumulate in the legs.
  • Thyroid disease: Hypothyroidism can cause swelling in the legs and feet. It may also cause facial swelling.
  • Medications: Some medications, such as amlodipine (Norvasc), can also cause edema.
Was this helpful?

Each type of heart failure reduces the heart’s ability to pump effectively.

Types of heart failure include:

  • left-sided
  • right-sided
  • congestive

Left-sided heart failure

The left side of the heart pumps blood out of the heart to the rest of the body. Left-sided heart failure can develop when the left ventricle (the lower left chamber of the heart) can no longer pump enough blood out of the heart and into circulation.

It can also occur when the left ventricle becomes too stiff and can’t fill with enough blood in between heartbeats. This keeps the heart from meeting the body’s requirements for oxygenated blood.

Left-sided heart disease typically involves edema in the lungs.

Right-sided heart failure

When blood returns to the heart, it enters the right atrium (the top right chamber) and moves to the right ventricle (the bottom chamber), which pushes blood into the lungs to receive oxygen.

When the right side of the heart weakens, blood coming in from the veins can start to back up. This is called right-sided heart failure, which usually results in edema in the lower extremities.

Congestive heart failure

The term congestive heart failure refers to a state of heart failure in which fluid buildup in the body is serious enough to require medical attention. It’s often used interchangeably with heart failure, which includes left and right heart failure.

In this instance, “congestion” is another word for fluid. This can result in edema in the lungs, abdomen, lower legs, and feet.

Other symptoms of heart failure

Heart failure can cause other symptoms in addition to edema. If you experience these symptoms, it’s best to seek medical attention. This is especially true if you’re a heart attack survivor or otherwise at high risk for heart failure.

Other heart failure symptoms include:

Was this helpful?

Treating edema usually means treating the underlying cause of the swelling. Treating heart failure may involve the use of medications, including:

  • diuretics to reduce fluid levels in the body
  • medications like ACE inhibitors and ARBs or ARNI to help the blood vessels relax, so circulation is a little easier
  • beta blockers and ivabradine to reduce the burden on the heart
  • mineralocorticoid receptor antagonists (MRAs)
  • SGLT2 inhibitors

In very serious cases, implantable pumps or defibrillators are needed to help the heart muscle keep up with the body’s demand for blood. In the most severe cases of heart failure, a heart transplant may be necessary.

Treating edema may include:

  • wearing compression stockings to help increase the pressure in your lower legs, which may help push blood up to the heart
  • exercising to help the leg muscles affected by edema work harder and pump blood back to the heart
  • elevating the swollen part of your body above your heart to help keep blood returning to central circulation

Edema is a common symptom of heart failure, but it can also be caused by other conditions.

With heart failure, fluid builds up because the body’s circulatory system isn’t operating as strongly as it normally would. This is due to a weakening or stiffening of the heart muscle.

If you notice swelling but know of no underlying medical reason for it, it’s best to see a doctor as soon as you can. Even if the cause isn’t heart failure, you’ll want to know why the swelling has developed and how it can be treated or prevented in the future.

Read this article in Spanish.