Leg pain and congestive heart failure: what to know

When the heart cannot circulate blood effectively, pressure can encourage fluid to collect in the lower legs and ankles. This may cause heaviness, tight skin, aching or swelling that is worse after standing. Heart failure commonly comes with breathlessness, fatigue, cough or reduced exercise tolerance. Leg pain may instead reflect a muscle, joint, nerve or circulation problem. Atrial fibrillation and hypertension can be associated with heart failure, but a symptom is not a diagnosis.

If you have known heart failure, follow your prescribed fluid, salt, weight and medicine plan, and report a noticeable change in swelling or breathing. Do not stop diuretics or alter doses without advice. If symptoms are new, arrange a clinical assessment; the clinician may check your heart and lungs, compare both legs, review medicines and consider tests. Note when pain occurs, whether swelling is equal on both sides, and any change with walking or elevation.

Get urgent help for severe or rapidly worsening breathlessness, chest pain, fainting, confusion, blue lips or sudden weakness. Prompt assessment is also needed for a newly swollen, red, hot or very painful one-sided leg, particularly with breathlessness. Contact your heart-failure team quickly if swelling or breathing worsens or usual activity becomes harder.

Ask whether your leg symptoms fit fluid retention, circulation or another cause; how to monitor swelling and weight; and whether a chronic disease review or further assessment is needed.