Ankle Swelling in COPD May Be From Pulmonary Hypertension

A Common COPD Complication that May Cause Edema

Swollen foot
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"I have COPD and my legs and ankles started swelling. Is this related to my lung disease?"

You may be experiencing  a serious but common complication of COPD that causes the swelling. This complication is known as pulmonary hypertension.

Pulmonary Hypertension as a Cause of Ankle Swelling

Pulmonary hypertension means that your blood pressure is higher than normal in your heart and in your lungs. It's a serious condition, as the increased pressure in your heart and lungs causes damage to 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 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 and between the lungs, making 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 right-sided heart failure or dysfunction, in which the right side of your heart becomes enlarged and does not 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)

In the majority of people with COPD, pulmonary hypertension is mild to moderate. Only in a small group of people does it become severe. People with pulmonary hypertension that is 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. Keeping the fluid levels in your body balanced is also a strategy to minimize symptoms from pulmonary hypertension. 

Specifically, you should follow your doctor's instructions regarding treatment of your COPD and pulmonary hypertension, including medications, exercise, salt and water restrictions, and physical therapy, if prescribed or recommended.

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.

A Word From Verywell

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.

Sources:

Centers for Disease Control and Prevention. Pulmonary Hypertension Fact Sheet

Hurdman J et al. Pulmonary hypertension in COPD: results from the ASPIRE registry. European Respiratory Journal. 2013 41:1292-1301.

Zangiabadi A, De Pasquale CG, Sajkov D. Pulmonary hypertension and right heart dysfunction in chronic lung disease. Biomed Res Int. 2014;2014:739674.

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