[51F] With severe calf and foot pain, swelling, and shortness of breath

Patient Description

A 51-year-old female presents with severe pain and swelling in her calves and feet, which has been progressively worsening over the past six months. The pain is described as throbbing, burning, and tingling, and affects both legs, with one leg being more swollen than the other. The swelling leaves a dent when pressed and appears bluish. The pain is constant and exacerbated by prolonged walking, sitting, or lying down. The patient also reports recent shortness of breath but denies any chest pain. There is noticeable redness and warmth in the swollen leg. The patient has a history of smoking cigarettes and previously used methamphetamines but has been clean for about a month. She has a medical history of Discoid lupus and is not currently taking any medications. There are no known allergies or adverse reactions to medications, and the patient is unsure about her family medical history due to being adopted.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are several serious conditions that could be causing your symptoms:

  1. Deep Vein Thrombosis (DVT): This is a condition where a blood clot forms in a deep vein, usually in the legs. Symptoms include swelling, pain, redness, and warmth in the affected leg. Given that one leg is more swollen than the other and you have shortness of breath, this could be a sign of a blood clot that has traveled to your lungs, which is a medical emergency.

  2. Peripheral Artery Disease (PAD): This condition occurs when the arteries that supply blood to your limbs become narrowed or blocked. Symptoms include leg pain, especially when walking, and swelling. Smoking is a significant risk factor for PAD.

  3. Chronic Venous Insufficiency: This occurs when the veins in your legs are not working effectively, making it difficult for blood to return to the heart. This can cause swelling, pain, and skin changes.

  4. Lymphedema: This is swelling that generally occurs in one of your arms or legs due to a blockage in your lymphatic system. It can cause swelling, pain, and changes in skin color.

  5. Complications from Lupus: Discoid lupus primarily affects the skin, but systemic lupus can affect your blood vessels and lead to similar symptoms.

What you can do

Given the severity and duration of your symptoms, it is crucial to seek immediate medical attention. Here are the steps you should take:

  1. Go to the Emergency Room: Given the possibility of a blood clot and your shortness of breath, you should go to the emergency room immediately. If you are alone or unable to get there yourself, call 911 for an ambulance.

  2. Avoid Walking or Standing for Long Periods: Until you receive medical attention, try to keep your legs elevated when sitting or lying down to reduce swelling.

  3. Do Not Ignore Symptoms: If you experience worsening pain, increased swelling, or any new symptoms like chest pain or severe shortness of breath, seek emergency medical care immediately.

  4. Inform Medical Staff About Your History: Make sure to inform the medical staff about your history of Discoid lupus, smoking, and previous methamphetamine use, as these can all be relevant to your condition.

Remember, I am not a doctor, and this advice is based on the information you have provided. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment.

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7 mo ago

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

People Also Ask


What are the symptoms of Deep Vein Thrombosis (DVT)?

Symptoms of Deep Vein Thrombosis (DVT) include swelling, pain, redness, and warmth in the affected leg. If a blood clot travels to the lungs, it can cause shortness of breath, which is a medical emergency.


How does smoking affect Peripheral Artery Disease (PAD)?

Smoking is a significant risk factor for Peripheral Artery Disease (PAD) as it contributes to the narrowing and blockage of arteries, reducing blood flow to the limbs and exacerbating symptoms like leg pain and swelling.


What is the difference between Chronic Venous Insufficiency and Lymphedema?

Chronic Venous Insufficiency occurs when veins in the legs fail to return blood to the heart effectively, causing swelling and skin changes. Lymphedema is swelling due to a blockage in the lymphatic system, often affecting one limb and causing skin color changes.


Can Discoid Lupus lead to complications affecting the legs?

Discoid Lupus primarily affects the skin, but if it progresses to systemic lupus, it can affect blood vessels and potentially lead to symptoms like swelling and pain in the legs.


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