Heart Failure Warning as One of the Most Common Symptoms May Appear in the Ankles

A commonly overlooked symptom puffy ankles and legs may indicate a much more serious and potentially fatal health condition, according to the British Heart Foundation (BHF). Medical experts are urging the public to pay close attention to this subtle but telling sign of heart failure.

Heart failure occurs when the heart becomes too weak or stiff to pump blood efficiently throughout the body. Although it is usually a chronic and incurable condition, with proper treatment, symptoms can often be managed for years.

In a recent advisory, the BHF emphasized the importance of recognizing early warning signs. “You may hear your doctor or nurse talk about ‘stages of heart failure’ or ‘classes of heart failure,’” the organization explained. “This refers to a classification system that helps to describe how bad your symptoms are and how much they affect the quality of your daily life.”

The most commonly used system, known as the New York Heart Association (NYHA) classification, categorizes heart failure into four classes based on physical limitations and symptom severity. Common signs include breathlessness, fatigue, and irregular heartbeat.

However, the NHS adds another key symptom not included in the NYHA scale—swollen ankles and legs. This condition, known as oedema, results from fluid retention and is considered “one of the most common symptoms of heart failure.”

Oedema can severely affect mobility and often worsens later in the day, although it may appear improved in the morning. Medical News Today explains that when the heart fails to pump effectively, pressure builds in the blood vessels, forcing fluid into surrounding tissues and leading to swelling.

Typical signs of oedema include puffy or swollen ankles, feet, or legs, shiny or stretched skin, colour changes, stiffness, and skin that retains an indentation when pressed.

While oedema can signal heart failure, it may also result from other conditions such as:

• Prolonged sitting or standing
• High salt intake
• Obesity or pregnancy
• Certain medications (e.g., blood pressure drugs, contraceptives, antidepressants)
• Injuries, insect bites, kidney or liver problems
• Blood clots or infections

Other hallmark symptoms of heart failure include shortness of breath (especially when lying down), persistent fatigue, dizziness, and fainting. Less common signs include a chronic cough, bloating, appetite changes, weight fluctuation, confusion, palpitations, and psychological effects like depression and anxiety.

The NHS advises: “See your GP if you experience persistent or gradually worsening symptoms of heart failure.” For sudden or severe symptoms, they urge: “Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department as soon as possible.”