[41F] Experiencing leg pain and swelling with associated systemic symptoms

Patient Description

A 41-year-old female presents with red calves, tight skin on the legs and feet, swelling in the feet and legs, dizziness, fatigue, weight gain, headaches, and shortness of breath. She reports a throbbing pain in her calves that is constant and rates it as a 4-5 out of 10 in severity. The patient also experiences dizziness when standing up, which has been occurring for a few weeks, rated at a 2 out of 10 in severity. Headaches are a constant issue for the patient, rated at a 3 out of 10 in severity. Shortness of breath occurs mostly when moving around, also rated at a 3 out of 10 in severity. The patient has a history of a clotting disorder diagnosed in 2005 and obesity diagnosed in 1999. She leads a sedentary lifestyle, sitting for long periods. Current medications include Temazepam, Tizanidine, Hydrochlorothiazide, Diltiazem, and Amitriptyline. No recent injuries, chest pain, palpitations, fever, or coughing up blood have been reported.

Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be contributing to your symptoms:

Deep Vein Thrombosis (DVT): This is a blood clot in a deep vein, usually in the leg. DVT can cause leg pain or swelling, but also can occur with no symptoms. You're at higher risk for DVT if you have a clotting disorder, are obese, or sit for long periods. The redness and warmth over your calves could be a sign of this.
- Treatment typically involves blood thinners to break up the clot and prevent new ones from forming.
Venous Insufficiency: This is a condition where the veins have problems sending blood from the legs back to the heart. It can cause pain, swelling, and skin changes in the legs. Obesity and long periods of sitting can increase your risk.
- Treatment often involves compression stockings, exercise, and elevating your legs.
Heart Failure: This is a condition where the heart doesn't pump blood as well as it should. Symptoms can include weight gain, swelling in the legs and feet, and shortness of breath.
- Treatment typically involves medications to improve heart function and lifestyle changes.
Side Effects of Medication: Some of your symptoms could be side effects of the medications you're taking. For example, diltiazem can cause swelling in the legs and feet, and amitriptyline can cause weight gain and dizziness.

What you can do

You should seek immediate medical attention given your symptoms and history of a clotting disorder. In the meantime, try to elevate your legs when sitting and move around every hour or so to improve blood flow.

What you should look out for

Seek immediate medical attention if you experience chest pain, difficulty breathing, fainting, or if your symptoms significantly worsen. These could be signs of a more serious condition like a pulmonary embolism (a blood clot in the lungs) or heart failure.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

Top picked over-the-counter products for Venous Insufficiency and Varicose Veins Management