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Old 03-31-2004, 05:14 PM   #1
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emphysema + swollen ankles

My mother is 77 and has emphysema. She is on oxygen 24/7. She is legally blind and in Aug broke her wrist & hip. She hardly moves from a chair all day long. She lives on her own. I am now noticing her ankles are swollen. The dr did give her water pills. Is this a sign of heart failure?

 
Old 03-31-2004, 10:34 PM   #2
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Re: emphysema + swollen ankles

Quote:
Originally Posted by mrsstats
My mother is 77 and has emphysema. She is on oxygen 24/7. She is legally blind and in Aug broke her wrist & hip. She hardly moves from a chair all day long. She lives on her own. I am now noticing her ankles are swollen. The dr did give her water pills. Is this a sign of heart failure?

Everyone who has respiratory disease has some measure of heart failure. The heart is a muscle.

The way the body works is that blood is pumped into the lungs where gases are exchanged. Carbon dioxide is released, and oxygen is picked up. That new oxygenated blood goes back to the left side of your heart into the atrium, where the heart keeps some for itself, and squeezes the rest through a valve into the left ventricle, and it's then pushed out to the body. The blood nurishes the cells and picks up the waste products and the used blood gets sent back to the heart through the veins. Once the blood reaches the heart, it fills the right atrium, and is squeezed down into the right ventricle and sent to the lungs to exchange gases again. After it does that, it goes through the left side of the heart as I described earlier. It's a continues action with all sides working together to keep the blood moving.

When someone has respiratory disease, the gas exchange is impaired, especially in emphysema. The body isn't getting the oxygen it needs to survive (hence the need for home oxygen). So in order to compensate for that lack of oxygen, the heart works harder to pump more blood through the body. It gets tired and needs some help, so like a body builder who wants to lift more weights to win that competition, the right side of the heart increases in size so that it can be more effecient in sending blood to the lungs to do the gas exchanges. Bulking up (enlarging), helps the heart to pump more blood into the lungs.

And it keeps doing that until the heart just can't enlarge anymore. (sorry to be so simplistic, but I could go on for pages. I just wanted you to see the basic function of the way the heart works).

With someone who has emphysema, their ability to exchange gases is impaired. The lungs are made up of chambers, branches and alveoli. Think of a bunch of grapes. The big stems are the main brances of the lungs, the smaller ones leading off them are the smaller branches of the lungs, and the grape clusters on each little stem are the alveoli of the lungs. The alveoli is where the gas exchanges take place. The lungs are elastic-like. Meaning that they expand and bounce back to shape.

In emphysema the lungs lose that elastic effect and when they expand, they stay expanded. The nitrogen that would normally be expelled, builds up and keeps the lungs from retaking their shape.... hence the barrel-like chest-abdomens of emphysema patients.

So between the body's need for oxygen, the lung disease preventing proper gas exchange, and the heart having to work harder and harder in order to fuel the body with its needs, the heart does eventually fail. It starts with the right side and then leads to the left side failing as well in time. The venous system gets backed up (kind of like bad plumbing), and leads to swelling in the lower limbs.

*Edited to correct spelling*

Last edited by Katyana; 04-01-2004 at 08:42 PM.

 
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Old 04-01-2004, 05:53 PM   #3
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Re: emphysema + swollen ankles

Thank you so much for the explaination. I just needed to know if there was anything more to be done and understand. You were most helpful

 
Old 04-01-2004, 08:48 PM   #4
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Re: emphysema + swollen ankles

You're welcome. I know alot about this topic because I lived through it with my own mother when I was a young teenager (14 and 15 years old). I learned all I could about the topic and even had the hospital teach me how to do some things so that I could look after her at home when she wasn't so critical and needing intensive care. Her constant shortness of breath was very scarey to me; and her acute episodes were terrifying. The only way I could cope was to learn and understand what was happening to her, and what I could do to help her. So I did.

If you need any more information, feel free to post back and I'll try and help you the best that I can.


Quote:
Originally Posted by mrsstats
Thank you so much for the explaination. I just needed to know if there was anything more to be done and understand. You were most helpful

 
Old 04-04-2004, 10:40 AM   #5
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Re: emphysema + swollen ankles

Another part of it is that her lungs get harder to pump blood through if she's constantly low on oxygen. The oxygen 24/7 will help this, but it's like sucking a golf ball through a garden hose if she gets bad. This can cause her right heart to fail, and can give her swollen ankles. All they can do at that point is give her water pills, which basically just give her less blood to pump.

 
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