[24F] With swelling in legs, ankles, feet, and thighs, and throbbing headache

Patient Description

A 24-year-old female presents with swelling in the legs, ankles, feet, and thighs for the past two days. The swelling is accompanied by throbbing pain, rated 4 out of 10 in intensity, and worsens with activities such as sitting, walking, driving, and climbing stairs. No injuries to the legs were reported, but the patient has had periods of prolonged sitting. There is no redness or warmth in the swollen areas. Additionally, the patient has been experiencing a throbbing headache located between the ears for the past two days, rated 2 out of 10 in intensity, with no relief from any measures. The patient has a history of similar headaches. The patient also reports shortness of breath, chest pain, sudden weight gain, and difficulty breathing while lying down. There is a family history of heart disease, high blood pressure, and diabetes. The patient uses weed and vapes and is not up to date with vaccinations, including the flu shot and COVID-19 vaccine. Medical history includes a shellfish allergy and a diagnosis of genital herpes in 2017. The patient has adverse reactions to medications like Tylenol, ibuprofen, and Advil, causing vomiting. Currently, the patient is not taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Swelling in Legs, Ankles, Feet, and Thighs

  1. Edema: This is a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body. It can be caused by prolonged sitting, which you mentioned is part of your work with DoorDash.
  2. Heart Failure: Given your family history of heart disease and your symptoms of shortness of breath, chest pain, sudden weight gain, and difficulty breathing while lying down, heart failure is a possibility. Heart failure can cause fluid to build up in your legs and other parts of your body.
  3. Venous Insufficiency: This occurs when the veins in your legs have trouble sending blood back to your heart, leading to swelling.

Throbbing Headache

  1. Tension Headache: This is the most common type of headache and can be caused by stress, poor posture, or prolonged periods of sitting.
  2. Migraine: Although your headache is not very intense, migraines can sometimes present with throbbing pain and can be triggered by various factors, including stress and changes in routine.

Unifying Diagnoses

  1. Heart Failure: This could potentially explain both the swelling and the shortness of breath, chest pain, and difficulty breathing while lying down.
  2. Venous Insufficiency: This could explain the swelling in your legs, especially given your prolonged periods of sitting.

What you can do

Swelling in Legs, Ankles, Feet, and Thighs

  • Elevate Your Legs: Try to elevate your legs above the level of your heart when you are sitting or lying down to help reduce swelling.
  • Compression Stockings: Wear compression stockings to help improve blood flow and reduce swelling.
  • Stay Active: Take breaks to walk around and stretch your legs if you have to sit for long periods.
  • Limit Salt Intake: Reducing your salt intake can help decrease fluid retention.

Throbbing Headache

  • Hydrate: Make sure you are drinking enough water throughout the day.
  • Rest: Try to rest in a quiet, dark room to alleviate the headache.
  • Over-the-Counter Pain Relief: Since you have adverse reactions to common pain medications, consult your doctor for alternative options.

General Recommendations

  • Seek Medical Attention: Given the combination of your symptoms, it is important to see a healthcare provider as soon as possible to rule out serious conditions like heart failure.
  • Track Symptoms: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

Given the severity of your symptoms and the possibility of life-threatening causes, you should seek medical care as soon as you can. Reasons to seek care even more urgently include:

  • Worsening Shortness of Breath or Chest Pain: These could be signs of a serious heart condition.
  • Severe Swelling or Pain: If the swelling or pain in your legs becomes severe, it could indicate a more serious issue like a blood clot.
  • Fainting or Dizziness: These could be signs of a serious underlying condition that needs immediate attention.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago


People Also Ask


What causes swelling in the legs, ankles, feet, and thighs?

Swelling in the legs, ankles, feet, and thighs can be caused by fluid retention, known as edema. It can result from prolonged sitting, heart failure, or venous insufficiency, where veins struggle to return blood to the heart.


How can prolonged sitting contribute to leg swelling?

Prolonged sitting can lead to poor circulation in the legs, causing blood and fluid to pool in the lower extremities, which can result in swelling.


What are the potential causes of a throbbing headache?

A throbbing headache can be caused by tension headaches, which are often due to stress or poor posture, or migraines, which can be triggered by various factors including stress and changes in routine.


Why is it important to seek medical attention for symptoms like shortness of breath and chest pain?

Shortness of breath and chest pain can be symptoms of serious conditions like heart failure. Seeking medical attention is crucial to rule out life-threatening issues and to receive appropriate treatment.


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