Why Does COPD Cause My Legs and Ankles to Swell?

This symptom, known as edema, is from a complication of COPD

Swollen foot
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Question: Why does chronic obstructive pulmonary disease cause my legs and ankles to swell up?

Answer: Technically, chronic obstructive pulmonary disease (or COPD, for short) doesn't make your legs and ankles swell up. Instead, it's a serious complication of COPD that causes the swelling. This complication is known as pulmonary hypertension.

Pulmonary hypertension means that your blood pressure is higher than normal in your heart and in your lungs.

It's a serious condition: the increased pressure in your heart and lungs causes damage to those important blood vessels. Because of this, blood backs up in the veins in your body.

When blood backs up in veins throughout your body, fluid can leak into the surrounding tissues. Because of the effects of gravity, fluid pools in the lowest parts of your body — your feet, ankles and legs — and makes them swell up. In technical medical terms, this swelling is known as "edema."

Pulmonary Hypertension in COPD

Unfortunately, pulmonary hypertension is pretty common in people who have COPD. It occurs because the blood vessels that carry blood between your heart and lungs become hard and narrow.

This raises the blood pressure specifically in the blood vessels within the lungs and between the lungs, and makes it much more difficult for the right-hand side of your heart (the part of the heart that moves blood between your heart and your lungs) to pump.

Pulmonary hypertension can lead to a specific type of heart failure called cor pulmonale, in which the right side of your heart becomes enlarged and doesn't pump as efficiently. It's linked to a higher risk of COPD exacerbation and lower survival.

In addition to swelling of your feet, ankles and legs, pulmonary hypertension can cause the following symptoms:

  • shortness of breath during routine activities
  • a faster or racing heartbeat
  • fatigue
  • chest pain, or pain in your upper right abdomen
  • decreased appetite
  • bluish colored lips (shows your blood isn't carrying enough oxygen)

Pulmonary hypertension is a serious medical condition. People with pulmonary hypertension that's bad enough to cause significant swelling in their lower extremities may find it difficult to perform many daily tasks.

Treating Swelling in COPD and Pulmonary Hypertension

There's no treatment that's specific for leg and ankle swelling in pulmonary hypertension and COPD. Instead, treating the underlying conditions that caused the swelling in the first place may help take some of the stress off your heart and lungs, and ultimately reduce the swelling.

Specifically, you should follow your doctor's instructions regarding treatment of your COPD and pulmonary hypertension, including medications, exercise and physical therapy, if prescribed. If your swelling and other symptoms seem to be getting worse, your doctor may decide to make changes in your medication regimen, including oxygen therapy.

There are a few things you can do at home to help the swelling. Putting your feet up higher than your heart and as often as possible will help reduce the edema in your lower extremities. If the swelling is particularly problematic, it is best to talk with your doctor, as she may recommend diuretic therapy, which encourages your body to eliminate unnecessary fluids.


Chaouat A et al. Pulmonary hypertension in COPD. European Respiratory Journal. 2008 Nov;32(5):1371-85.

Shujaat A et al. Pulmonary hypertension and chronic cor pulmonale in COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2007 Sep; 2(3): 273–282.

U.S. National Library of Medicine. Cor Pulmonale fact sheet. Accessed March 12, 2016.

U.S. National Library of Medicine. Pulmonary Hypertension fact sheet. Accessed March 12, 2016.

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