Heart Failure and Lower Extremity Edema: Understanding the Connection with Pericarditis

Pericarditis, an inflammation of the pericardium, can lead to a range of complications, including lower limb swelling. This phenomenon is often linked to secondary effects such as pericardial adhesions, which restrict the heart's normal function. When the heart's ability to relax and fill with blood during diastole is compromised, it results in reduced cardiac output.

How Pericarditis Affects Blood Circulation

As the heart struggles to pump efficiently, pressure builds up in the venous system. This increased venous pressure hampers the return of blood to the right atrium, leading to systemic congestion. One of the visible signs of this condition is jugular venous distension, which indicates elevated pressure in the circulatory system.

Fluid Accumulation and Organ Involvement

With impaired blood flow, congestion spreads to various organs. The liver becomes engorged with blood, potentially leading to hepatic dysfunction and the development of ascites. Portal hypertension may also occur due to increased resistance in blood flow through the liver. These changes contribute to the overall fluid imbalance in the body.

Peripheral Edema: Why the Legs Are Affected

One of the most noticeable symptoms in such cases is peripheral edema, particularly in the lower extremities. The reason for this localization lies in both gravity and tissue structure. Because the legs are the lowest part of the body when standing, fluid tends to accumulate there. Additionally, the connective tissue in the lower limbs is more loosely arranged, allowing for greater fluid retention.

This fluid shift occurs as blood remains in the peripheral circulation for extended periods, eventually leaking into the third space—areas of loose tissue where fluid can collect abnormally. This mechanism explains why swelling is commonly observed in the legs and feet of patients with pericarditis-related heart dysfunction.