If you’re living with heart failure, you’re likely on the lookout for any related symptoms, such as chest pain or shortness of breath. However, one symptom that’s less well known involves what some people call “leaking legs” — fluid seeping from the skin of swollen legs.

If you’ve noticed edema (swelling) in one or both legs, be sure to talk to your doctor — particularly if you have fluid leaking into the skin. Leaking legs can be a serious complication of edema and needs to be treated as soon as possible.

Read on to learn more about edema, how it can lead to leaking legs, and what you can do to manage it.

What Are Leaking Legs?

Leaking legs are a result of peripheral edema, a type of swelling due to excess fluid retention in the lower legs (or other parts of the body). Common symptoms of peripheral edema include:

• Sensations of heaviness in the legs
• Puffy or swollen leg tissue
• Stretched skin or skin that appears to dent after being pressed (also called “pitting”)

A buildup of fluid may also cause sudden weight gain.

Many MyHeartDiseaseTeam members have experienced peripheral edema. One member wrote, “After being up for about an hour, my ankles would start to swell and, by evening, they’d be grossly swollen.”

Another said, “I can’t get rid of the fluid retention in my legs.”

Peripheral edema is a common symptom of heart failure. If it isn’t managed well, fluid can build up and break through the skin and leak through the skin. This is known as lymphorrhea and sometimes called “leaky legs.”

Leaky or “weepy” legs need prompt medical attention. Left untreated, the fluid can cause open wounds that don’t heal or lead to cellulitis — a bacterial infection that can become serious or even life-threatening.

“Swelling of feet and legs with a weeping sore of one leg. The cardiologist said it is a combination of venous insufficiency and congestive heart failure. Going to the wound care clinic,” a MyHeartDiseaseTeam member shared.

Peripheral edema swelling — and possible leaking through the skin — can be caused by issues with the heart itself, certain medications to help treat heart disease, or other unrelated factors and conditions.

How Are Edema and Leaking Legs Linked to Heart Failure?

Heart failure is one of the types of heart disease that can cause swollen legs, which potentially become leaky. Heart failure is commonly linked to a condition called cardiomyopathy.

In people with cardiomyopathy the heart muscle is damaged and can’t pump blood efficiently. There are several types, including:

• Dilated cardiomyopathy — The heart chambers become enlarged and weakened.
• Hypertrophic cardiomyopathy (HCM) — The heart muscle, especially in the left ventricle (the heart’s main pumping chamber), becomes thick.

In HCM, the thickened heart muscle may look stronger, but it doesn’t work better. In fact, it may pump less effectively and have trouble relaxing between beats. This happens because the muscle cells are not aligned properly and may have scar tissue between them. HCM is usually a genetic (inherited) condition.

Other forms of cardiomyopathy or heart conditions can also cause the heart muscle to become stiff, leading to heart failure with preserved ejection fraction — a type of heart failure where the heart can contract but not relax normally.

Another cause of heart failure is the heart valves dysfunction. When a valve doesn’t open or close the right way, it can put strain on the heart. In some cases, valve repair or replacement may be needed to restore healthy heart function.

Damage in the left ventricle can lead to left-sided heart failure. Over time, this can affect the right ventricle, leading to right-sided heart failure. When the right side of the heart isn’t working properly, it has trouble moving blood back through the veins. This causes fluid to back up, often pooling in the legs and ankles.

Several chronic conditions can also weaken and stiffen the heart and may lead to heart failure. These include:

• High blood pressure
• Arrhythmia (irregular heartbeat)
• Coronary artery disease
• Past heart attacks
• Viral infections that damage the heart muscle

When the heart’s ability to pump blood decreases, the kidneys may try to help by retaining water to help maintain blood pressure. However, when the body holds more water, some can leak out of blood vessels and pool in the lower legs, leading to swelling and, in some cases, leaking legs.

Some Heart Medications May Cause Peripheral Edema

Some treatment options for heart disease may have side effects, including peripheral edema. This includes drugs that treat high blood pressure and corticosteroids, which are sometimes used to treat myocarditis (inflammation of the heart muscle) or other conditions.

Calcium channel blockers are a class of blood pressure medications that are well known for causing peripheral edema. These medications work by relaxing the arteries, which carry blood away from the heart. When these blood vessels dilate (expand), they hold more fluid. That extra fluid can leak into surrounding tissues, causing swelling — and in some cases, leaking legs.

Some other medications can also play a role:

• Angiotensin‐converting enzyme (ACE) inhibitors — also used to treat high blood pressure — have been found to reduce edema when used with calcium channel blockers.
• Beta-blockers don’t commonly cause edema.
• Corticosteroids such as prednisone act directly on the kidneys to retain salts and fluids. This effect may cause extra pooling in the legs, and may lead to swollen and leaking legs.

If you think a medication might be causing your legs to swell or leak, talk to your healthcare provider. They can help you adjust your treatment plan if needed.

Other Potential Causes of Peripheral Edema

Swollen legs — with or without leaking fluids — may have causes other than heart disease or heart medications. If you have peripheral edema, your doctor may consider other risk factors, such as:

• Autoimmune disorders like lupus or rheumatoid arthritis
• Chemotherapy
• Inflammation following an injury to the leg, such as a sprain or burn
• Chronic kidney disease
• Pregnancy
• Long periods of standing or sitting
• Certain pain relievers, including naproxen
• Venous insufficiency, an issue in which blood has difficulty flowing back up from the legs to the heart

How To Manage Peripheral Edema To Help Prevent Leaking Legs

You can take steps to help relieve the pain and swelling associated with peripheral edema before it worsens and causes leaking legs.

Talk to your doctor about how to manage symptoms of swollen legs, including:

• Engaging in exercise or other forms of physical activity to help pump fluid back toward the heart
• Reducing sodium (salt) in your diet, which may lower fluid retention
• Raising your swollen leg above your heart, particularly when lying down or sleeping
• Taking a diuretic (“water pill”), a type of medication that helps your body get rid of extra fluid
• Wearing compression stockings, which gently apply pressure to the legs to help prevent fluid buildup

Importantly, compression stockings aren’t safe for everyone. People with poor circulation or peripheral artery disease may be at risk. Always ask your doctor before using them, and make sure to wear them as recommended.

“Feet elevated and wearing compression socks. Swelling has decreased considerably today,” a MyHeartDiseaseTeam member wrote.

Talk to Your Doctor if Your Legs Are Leaking

If you have swelling in your legs that gets worse or starts to leak fluid through the skin, it’s important to get medical advice right away. Leaking legs can be a sign that peripheral edema is progressing and may lead to serious complications if not treated promptly.

“Because of my congestive heart failure, my legs are carrying a lot of fluid, so much so that the fluid has nowhere to go but up through my skin.”

— A MyHeartDiseaseTeam member

One member described their experience with treating leaky legs: “Because of my congestive heart failure, my legs are carrying a lot of fluid, so much so that the fluid has nowhere to go but up through my skin. What the wound clinic is doing now is putting compression wraps on both legs and having me elevate them above my heart one hour at a time. Unfortunately, more ulcers (blisters) appeared since Monday and the sore is now wrapping around my ankle.”

Getting early treatment can help prevent infection, reduce discomfort, and protect your skin from further damage. Your doctor can recommend a plan tailored to your needs.

When Swelling Is a Medical Emergency

Some types of swelling need immediate medical attention. If you experience swelling in your chest, along with shortness of breath, chest pain, or tightness, seek emergency care right away. These may be signs of pulmonary edema (fluid buildup in the lungs), which can be life-threatening if not treated quickly.

Swelling in the legs can also signal a medical emergency. If your leg becomes swollen after sitting for a long time — such as after a long flight or car ride — you may have deep vein thrombosis (DVT), a blood clot in the leg. One leg being more swollen than the other is a common sign of DVT. This condition requires prompt diagnosis and treatment to prevent serious complications.

Let your doctor know right away if you notice these symptoms, or go to the nearest emergency room for care.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 62,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you experienced swollen or leaking legs? How have you managed these symptoms? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.