What Causes Severe Ankle Swelling?

Posted on Tue, 20 Oct 2015

Question: I have had swelling in my left ankle and above about 3 inches. The right swells a little, but not nearly as bad as the left. The left looks like I have sprained it by the end of the day. I went to my doctor and he did a battery of tests. ALT and Alk Phos. were a little above normal and so was my creatin (not sure of spelling). He also did a D Dimer test. Normal for that lab is 0-0.49, and mine is 4.35. He is going to schedule me for an ultrasound of both legs. I don't have redness or pain, and this swelling has been here for at least a year and has gotten worse. My question is, how can this be blood clot related with no symptoms and being present for this long? Also, his nurse, when she called said it indicated a possible heart problem. What kind of heart problem? Thank you.

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer:
Following explanations...

Detailed Answer:
Hi and thank you for asking!
I read your query and understood your concerns.

First of all your problems may be related to deep vein trombosis (DVT). Since the trombosis is on the deep veins of the leg you may have no redness or pain. The only abnormal finding may be ankle or leg swelling.

There is why you should do a Doppler ultrasound examinations of both legs to confirm / exclude the diagnosis of DVT.

Secondly one of the most common causes of leg swelling is heart failure (HF). This is why you should do also a cardiac echo to exclude / confirm the diagnosis of HF.

Hope this will be of help!
Wish you health!
Dr. Shehu
p.s: If you have more questions, please don't hesitate to ask me again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (56 minutes later)

Thank you for answering my question. One more, if it is heart failure causing the swelling, wouldn't both legs be swollen the same? The left is 3x more swollen and the right ankle doesn't have a lot of swelling at all. I am just worried since my heart my be involved. I am not ready to leave this earth yet. :)

Thank you.

Answered by Dr. Benard Shehu (4 hours later)

Brief Answer:
Following answer to your query...

Detailed Answer:
Hi back,

I would like to say that the leg swelling in patients with heart failure isn't always symmetric. This is due to local factors (like arthritis, thrombosis, lymph-edema etc.) that may be contributing on differences between legs.

Please keep in mind that the only examinations that confirm/exclude HF is cardiac echo. Since then there's a clinical suspicion for HF. More over patients with HF may be treated in the early stages and they may survive the disease.

For the moment you should stay calm and relaxed and wait for the cardiac echo results.

Wish you health!
Dr. Shehu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (2 hours later)

Thank you very much for your answers. I have not been able to talk with my doctor since the lab results came in. His nurse called and gave me the results. His office scheduled the leg ultrasound. I am not sure when I will see him. I have leg ultrasound tomorrow.

Thank you again for filling in until I see him.

Answered by Dr. Benard Shehu (2 minutes later)

Brief Answer:
Following answer to your query...

Detailed Answer:
Hi back,

It was my pleasure to assist you with my advises. You should wait for the test results and if you want you may upload those data so I would assist you further.

Wish you health!
Dr. Shehu

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar