Heart Disease and Your Feet (2024)

As February is American Heart Month, I thought this would be a good time to point out the connection between the heart and foot pain.

Foot pain is common and often ignored. Its causes range from tight-fitting shoes, increase in activity, and foot deformities like bunions to a lesser-known one that should never be ignored: heart disease.

Coronary artery disease (CAD) is a condition where the arteries in the heart become narrowed from plaque build-up. CAD increases your risk for developing another form of heart disease known asperipheral arterial disease (PAD), which occurs when the arteries in the extremities and feet narrow.

The main contributors to plaque build-up are fat and cholesterol. Eventually, plaque will break off and completely block the blood flow. In the heart, this creates a heart attack. When it happens in the extremities, it can cause pain and numbness in the legs and feet. It can also lead to amputations to parts of the feet.

Here are some signs relating to the legs and feet that may be a sign of heart disease:

• Absent hair growth on the feet.
• Dry, thinning, and/or shiny skin on your legs and feet.
• Unexplained atrophy (decreased muscle size).
• Changes in toenails, such as thickening, discoloration, or brittleness.
• Cold, numb feet and toes.
• Wounds that heal slowly.
• Diminished or absent pulses in your feet.
• Swelling of your lower legs, ankles and feet.
• Pain or cramping in the legs and feet when walking even short distances. In the early stages, this will usually go away when resting and then come back with activity. If the pain persists even when resting, it may be more advanced.

Risk factors for PAD include:

• Personal or family history of PAD, heart disease, heart attack or stroke.
• Over the age of 50.
• Current or former smokers.
• Diabetes.
• High blood pressure.
• High cholesterol.
• Sedentary lifestyle.

According to the CDC, approximately 6.5 million people aged 40 and older in the U.S. have PAD, while one in every 20 Americans over the age of 50 has the condition. Both men and women are affected by PAD, and African-Americans are more than twice as likely to have PAD than other racial and ethnic groups.

Diagnosing PAD involves discussing with your doctor any of the above symptoms; a physical examination that includes checking the pulses in your legs and feet; and an ankle-brachial index (ABI) exam, a painless procedure that compares the blood pressure in your lower legs to that in your arms. It takes only a few minutes and can be performed in the office.

Podiatrists are often one of the first providers to recognize PAD since we are always examining the feet and lower legs. That is why it is so important for people to get annual foot examinations. If patients are showing signs and symptoms of PAD, the ABI exam is abnormal, and they are not under the care of a cardiologist or vascular physician, I always refer to a vascular doctor/cardiologist.

Anyone with risk factors for, or experiencing symptoms of, PAD should schedule an evaluation as soon as possible. Do it for yourself – and for your heart.

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