In modern medicine, when leg edema is accompanied by shortness of breath and chronic fatigue, congestive heart failure can be suspected. Heart failure refers to a state where the heart cannot pump enough blood to meet the body's needs. Consequently, blood supply to various organs becomes insufficient, and because blood fails to return properly to the heart and stagnates, diverse symptoms emerge. Congestive heart failure specifically refers to cases where this blood stasis, or congestion, is prominent. When the heart's pumping function weakens, our body activates various complex mechanisms to compensate for it.
One of the earliest symptoms to appear is leg edema. When the heart cannot pump blood properly, blood flow volume to the kidneys decreases. The kidneys mistakenly perceive this as a lack of fluid in the body and activate an endocrine system known as the renin-angiotensin-aldosterone system. This system constricts blood vessels and increases the reabsorption of sodium and water in the kidneys, ultimately increasing the fluid volume in the blood. The increased fluid elevates pressure within the blood vessels, and due to this pressure, fluid components from the blood seep into the interstitial spaces between tissues outside the vessels, causing edema. Fluid easily pools in the lower body, such as the legs and ankles, under the influence of gravity, characteristically presenting as pitting edema, where an indentation remains when pressed with a finger.
Shortness of breath, or dyspnea, is closely related to left ventricular dysfunction. When the left ventricle weakens, it cannot properly pump oxygen-rich blood returning from the lungs to the entire body, causing blood to reflux into the lungs. This raises pressure in the pulmonary vessels, and fluid seeps around the pulmonary alveoli, leading to pulmonary edema. When fluid fills the lungs, gas exchange becomes difficult, causing shortness of breath with even slight movement. In severe cases, one may experience orthopnea, where breathing becomes harder when lying flat, or paroxysmal nocturnal dyspnea, where one suddenly wakes up breathless at night.
Chronic fatigue is also a common symptom of heart failure. Because the heart cannot supply sufficient oxygen and nutrients to tissues and organs throughout the body, the body remains in a persistent state of energy deficit. One tires easily from minimal activity and feels lethargic. In addition, unnecessary fluid accumulated in the body impairs cellular function and triggers inflammatory responses, which can further aggravate overall fatigue. Because there are various risk factors that can lead to heart failure, including hypertension, coronary artery disease, diabetes, and obesity, it is crucial to visit a clinic for accurate diagnosis and treatment if these symptoms persist. Heart failure is a condition whose symptoms can be alleviated and quality of life improved when detected and managed early.
