That swollen leg isn’t just a nuisance — it’s your body’s way of signaling for attention. Whether it’s from too much sitting or something more serious, paying attention now can save you trouble later. For those over 65, swelling could even point to a heart condition. Let’s uncover what’s behind the puffiness and how you can keep moving with confidence.
The silent red flags
"Leg swelling, or edema, happens when fluid builds up in the tissues of your lower extremities, often signaling an underlying medical condition," says Mazen Roumia, MD, an interventional cardiologist and independent member of the HonorHealth Medical Staff. "While it can result from non-medical causes like prolonged sitting or standing, high salt intake or medication side effects, it may also indicate serious issues such as deep vein thrombosis, kidney or liver disease, or heart failure."
Heart failure occurs when the heart can no longer pump blood effectively to meet the body’s needs. According to Dr. Roumia, this can lead to leg swelling often accompanied by other symptoms such as:
- Shortness of breath
- Chest pain
- Abnormal heart rhythms
- Swelling in other areas, such as the hands or abdomen
“Recognizing risk factors is key to preventing and detecting heart failure early,” Dr. Roumia says. Common risk factors include:
- Hypertension (high blood pressure)
- Coronary artery disease (narrowing in the heart arteries)
- Heart attacks
- Diabetes
- Valvular heart disease (defective heart valves)
Pulmonary hypertension, or high blood pressure in the lungs, is a condition that’s often overlooked — even when symptoms are present. “The right side of the heart isn’t designed to handle high pressures,” explains Dr. Roumia. “When lung pressures climb too high, the heart can struggle to push blood through the lungs' circulatory system.”
Other heart-related causes of leg swelling include:
- Atrial and ventricular septal defects (holes in the heart, typically diagnosed at birth)
- Certain abnormal heart rhythms
Another common cause is venous insufficiency, where weakened or damaged vein valves in the lower extremities prevent blood from flowing back to the heart, leading to pooling in the legs.
If you're experiencing leg pain, weakness, or difficulty walking, you may have peripheral arterial disease (PAD). Other symptoms include:
- Numbness
- Coldness in the calf or foot
- Color changes in the legs
- Sores that won’t heal
If you notice these signs, see your doctor.
When to take action
Chronic leg swelling isn’t usually an emergency, but Dr. Roumia advises scheduling an appointment with your primary care physician or cardiologist. They’ll likely start with an ultrasound of your leg veins and an echocardiogram to assess your heart.
Compression stockings are often the first non-medical treatment recommended to help improve blood flow. If your swelling is linked to pulmonary hypertension or heart failure, further tests will help guide the best treatment, which may include medication or surgery.
Leg swelling lasting more than a few days also warrants a visit to your doctor, Dr. Roumia advises. It could be due to chronic venous insufficiency or medication side effects, but only a healthcare provider can pinpoint the cause.
If leg swelling is accompanied by shortness of breath or chest pain, head to the emergency department immediately.
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