Case Study: What causes Feet Swelling?
As mentioned in my Instagram and Facebook, I was treating a patient that came in with chronic feet swelling. He had just done a blood test to confirm the cause of his feet swelling and the results would only be back in a few days time. At the first look of this condition, I was considering two organs that may be the root cause for such bad swelling. Based on my Western Medicine knowledge, the two organs are either Kidney or Heart. It can also be due to Liver and leg veins diseases.
Swelling is also known as edema which happens when small blood vessels leak fluid into nearby tissues. The leaked fluid accumulates and makes the tissue swell.
Symptoms of Feet Swelling
The classical presentation of edema or swelling at the legs is the swelling can make the legs feel heavy and can even affect walking for serious cases of swelling. Pitting is a common symptom of edema in which the tissue dents in and remains indented for a while when pushed in with a finger.
Causes of Feet Swelling
There are multiple causes for swelling at the feet. Here are some of them which I have considered on the first look of the presentation from the patient I was treating:
1. Kidney disease
Nephrotic syndrome due to damage of small blood vessels in kidneys can cause severe leg swelling. Read more about a Chinese Herb Corn Silk that can help clear swelling here.
2. Congestive heart failure
When the heart weakens and pumps blood less effectively, the fluid can slowly build up and result in feet swelling.
3. Liver disease
Cirrhosis or hardening of liver tissues can result in the retainment of fluid. The retained fluid can leak into the abdomen and lead to feet swelling.
4. Leg veins disease
Deep vein thrombosis or tumour in the leg veins can cause obstruction to drainage of fluid in the lower limbs.
My Western Medicine diagnosis and Traditional Chinese Medicine differential diagnosis
The patient presents as feet swelling for near to 2 months and complains of heart palpitations experienced as well. He was breathless as he talked and felt the legs were very heavy and required a wheelchair to help him move around.
Using Traditional Chinese Medicine pulse taking, his left Cun pulse felt weak and had no root, signifying that Heart energy was low. His right Cun pulse was equally floating, signifying the Lung energy was dissipated.
With Traditional Chinese Medicine tongue reading, his tongue showed as having the tip pale and the tongue body was engorged with teeth marks at the sides, signifying that Heart energy or qi was low.
My Western Medicine diagnosis for his feet swelling is due to a possible congestive heart failure and the Traditional Chinese Medicine differential diagnosis is weakened Heart-Lungs energy leading to Kidney water metabolism imbalance.
Follow up
The patient reported that the blood test results that came back showed that his B-type natriuretic peptide (BNP) is high at 950 pg/mL, indicating that he was having a heart failure, which resulted in his feet swelling.
