Leg pain can sometimes be caused by a heart condition. While most leg pain is due to issues in the legs themselves, like muscle strains, injuries, or problems with circulation, occasionally leg pain can be a sign of an underlying heart problem. In some cases, leg pain can even be one of the main symptoms of a serious heart condition.
Some of the key questions around the connection between leg pain and the heart include:
What heart conditions can cause leg pain?
Some of the heart conditions that can potentially cause leg pain include:
– Heart attack – A blockage in one of the heart’s arteries can cause leg pain, especially in the calf or thigh, as an early warning sign. This is because a lack of blood flow to the heart may also affect blood flow to the legs.
– Peripheral arterial disease – This condition causes the arteries that supply blood to the legs to become narrowed. It can lead to cramping or fatigue in the legs when walking.
– Aortic aneurysm – An enlargement or bulge in the body’s main artery, the aorta, puts pressure on nerves that go to the legs and causes pain. A ruptured aortic aneurysm is a medical emergency.
– Aortic dissection – This is a tear in the inner lining of the aorta. The pain often starts abruptly and spreads down from the chest to the legs.
Why does heart disease cause leg pain?
There are a few reasons why heart conditions can lead to leg pain:
– Reduced blood flow – Heart disease often impairs blood circulation. Narrowed arteries and blood clots mean less oxygen-rich blood reaches the legs, causing leg muscle pain.
– Nerve compression – Bulges or tears in major heart arteries can put pressure on nerves traveling to the legs, causing leg pain.
– Inflammation – Heart injury leads to inflammation that can spread to the legs. Inflamed nerves or muscles can result in leg aches.
– Referred pain – Pain signals from the heart may get crossed with nerve signals from the legs, leading to perceived pain in the legs.
What does the leg pain feel like with heart conditions?
The leg pain linked to heart disease can vary but some common characteristics include:
– Feels like cramping, aching, or fatigue in the hips, thighs, or calves.
– Occurs or worsens with walking and gets better with rest – this is called “intermittent claudication.”
– Pain, numbness or weakness may affect one or both legs.
– Feels like a “Charlie horse” cramp that may indicate an arterial clot.
– Can feel like shooting pain down the legs when caused by an aortic dissection.
– Leg swelling or change in temperature or color can accompany the pain.
How is heart-related leg pain diagnosed?
Doctors use several techniques to determine whether leg pain is related to a heart problem:
– Medical history – The doctor asks about risk factors and the onset of symptoms.
– Physical exam – Listening to the heart and feeling the pulses in the legs provides clues.
– Blood tests – Tests like cholesterol levels help assess heart disease risk.
– Leg ultrasound – This looks for blockages in the leg arteries.
– CT or MRI scans – Provides images of the aorta and arteries.
– Angiogram – Dye injected into the arteries shows blockages.
– Stress test – Checks blood flow to the heart during exertion.
Heart Conditions That Can Cause Leg Pain
Below is more detail on some specific heart conditions that can manifest as leg pain:
Heart attack
A heart attack, or myocardial infarction, occurs when blood flow to part of the heart muscle is cut off, usually due to a blockage in one of the coronary arteries. This can cause severe chest pain but some people also experience pain down the inner thigh or down one or both legs.
This leg pain with heart attacks results from the heart not pumping enough oxygen-rich blood to the lower extremities. The calf muscles in particular can spasm and ache due to oxygen deprivation. Sometimes the leg pain strikes before the chest pain. Getting immediate treatment for a heart attack is vital to minimize heart muscle damage.
Peripheral arterial disease
Peripheral arterial disease (PAD) happens when the peripheral arteries leading to the legs and arms become clogged with fatty deposits. This commonly affects the arteries in the pelvis and thighs. PAD causes leg pain because the legs do not get enough blood supply to meet their needs, especially during exercise.
Leg pain, cramping, tingling, or fatigue that comes and goes with walking or climbing stairs are classic signs of PAD-related “intermittent claudication.” Resting allows the leg pain to resolve. Left untreated, PAD can progress and lead to critical limb ischemia, wounds, and gangrene.
Aortic aneurysm
An aortic aneurysm is a weakened and bulging area in the aorta, which is the major blood vessel that comes out of the heart to carry blood to the body. Most aortic aneurysms occur in the abdomen. As the aneurysm enlarges, it can put pressure on nerves exiting the spine and heading to the legs. This compressed nerve can induce leg pain and sensations like numbness or tingling.
Sudden intense and excruciating pain radiating from the back down through the hips and legs can mean the aneurysm has ruptured and become a life-threatening emergency. Seek immediate medical help if such pain strikes.
Aortic dissection
An aortic dissection is an extremely dangerous event where the innermost layer of the aorta tears, allowing blood to infiltrate the wall layers. This can block off blood flow through the aorta branches. Dissections cause abrupt chest, back, and abdominal pain along with leg pain in over half of cases.
The leg pain results from reduced blood supply down the branches leading to the legs but also from pressue on nerve fibers running alongside the aorta. The leg pain may feel like stabbing, shooting sensations or burning pain down the thighs, calves or feet. Prompt surgery is required to prevent death from aortic dissection.
Getting Evaluated for Heart-Related Leg Pain
If you have new, unexplained leg pain or established heart disease, it’s important to see a doctor to assess whether your heart may be contributing to the leg symptoms. Here are some key steps in the evaluation process:
Medical history
The doctor will ask about your medical history, risk factors, and the pattern of your leg pain, including:
– What triggers the pain and what relieves it?
– Does it happen with exertion and go away with rest?
– Do you have cramping, fatigue, numbness, or tingling too?
– Does anything make the pain better like sitting or leg elevation?
– Do you have pre-existing heart disease or problems like high cholesterol?
Providing clear details helps determine whether heart disease could be playing a role.
Physical examination
A general physical exam provides additional clues through:
– Listening with a stethoscope for abnormal heart rhythms.
– Feeling the pulse in the legs to check for weaknesses that suggest reduced blood flow.
– Looking for swelling, skin changes, or hair loss in the legs.
– Applying pressure to the legs to assess for numbness or tingling.
– Checking for a larger aorta or pulsations that could indicate an aneurysm.
Blood tests
Blood tests check for signs of heart problems. Important tests include:
– Lipid profile – Measures LDL, HDL, total cholesterol, and triglycerides.
– High-sensitivity CRP – Elevated levels may signify inflammation around plaques in arteries.
– BNP levels – This substance goes up when the heart is under strain.
Imaging tests
Several imaging tests can reveal issues with heart arteries and blood flow:
– Leg artery ultrasound uses soundwaves to identify blockages.
– CT angiogram provides 3D images of the aorta and leg arteries.
– MRI angiography looks at blood vessels and flow without x-rays or dye.
– Cardiac stress test assesses how well the heart handles exertion.
– Angiography involves injecting dye into the arteries to pinpoint narrowings.
Referral to a cardiologist
If heart disease is suspected, you will likely be referred to a cardiologist. This heart specialist has in-depth training to thoroughly evaluate your heart health and determine whether it is causing leg pain. More specialized tests of heart structure and function may be performed.
Treating Heart-Related Leg Pain
The treatment for leg pain related to heart disease depends on the specific heart condition involved but may include:
Medications
Medicines to treat high cholesterol, high blood pressure, blood clots, and poor circulation can improve leg blood flow and reduce leg pain. Commonly prescribed drugs include:
– Statins – Lower cholesterol and help prevent blood vessel plaques.
– Beta blockers – Reduce blood pressure and heart strain.
– Anticoagulants – Prevent blood clot formation.
– Antiplatelets – Make platelets less sticky and block clotting.
– Calcium channel blockers – Relax blood vessels and increase blood flow.
Surgical procedures
Several types of procedures can open blocked heart arteries:
– Angioplasty and stenting – A catheter with a balloon is inserted into the artery to widen it. A wire mesh stent is usually put in place to keep the vessel open. This restores blood flow and relieves leg pain.
– Bypass surgery – Blood flow is rerouted around severely blocked arteries using a grafted blood vessel taken from another site.
– Aneurysm repair – The weakened section of aorta is reinforced or replaced.
– Aortic dissection repair – The torn layers of the aorta are fixed via open heart surgery.
Lifestyle changes
Adopting heart-healthy lifestyle changes reduces cardiovascular risk and improves leg blood flow and pain, including:
– Quitting smoking immediately to avoid blood vessel damage.
– Starting a regular exercise program like walking, swimming, or biking.
– Eating a diet centered on vegetables, fruits, nuts, whole grains, and lean proteins.
– Losing weight if overweight or obese.
– Limiting alcohol and sugary drinks.
– Reducing stress through techniques like yoga, meditation, or tai chi.
When to See a Doctor for Leg Pain
In some cases, leg pain can be the first noticeable sign of an undiagnosed heart problem. Call your doctor promptly if you have:
– New leg pain or cramping that comes and goes, particularly with exertion.
– Leg pain combined with chest discomfort or shortness of breath.
– Sudden, severe pain extending from the chest down the legs.
– Known heart disease and new onset of leg pain.
– Risk factors like smoking, high blood pressure, or family history of heart disease.
– Numbness, tingling, weakness, or cold sensation in the legs.
– Pain accompanied by leg swelling or skin color changes.
While most causes of leg pain are harmless, don’t dismiss heart-related concerns. Catching a serious issue early makes a difference in preserving heart muscle and function. Describe your symptoms fully to your doctor and ask about whether your heart needs evaluation. Getting the right diagnosis leads to the appropriate treatment.
Conclusion
Leg pain can be a surprising yet telling symptom of an underlying heart problem in some cases. Cramping, fatigue, or achiness in the hips, thighs or calves may be the only sign of reduced blood flow from heart vessel blockages. Severe, abrupt pain radiating down the legs can signal an aortic aneurysm or tear.
Doctors can determine if heart disease is triggering leg pain based on risk factors and tests for reduced blood flow and nerve compression. Addressing the heart issue is key to resolving the leg pain. Lifestyle changes, medications, stents, or surgery all help restore proper blood circulation and allow legs to feel strong and pain-free once again.