Chronic leg oedema, ulceration and heart failure: a potentially deadly and often neglected combination

Chronic leg ulceration may often be accompanied and exacerbated by the presence of oedema, a common health problem that can cause ulceration, which if left untreated can require amputation. Current clinical consensus indicates compression as the recommended treatment for oedema. While cardiac function is also known to influence oedema, it is rarely considered a parameter of wound management. This article presents a case study of a patient with oedema and ulceration, who avoided a scheduled amputation when lesions healed following the optimisation of cardiac function. The patient had right-sided heart failure with preserved ejection fraction. After fluid drainage, the ulcers began to heal. The case raises the question of cardiac optimisation of leg ulcer patients. This case highlights the potential role of cardiac management in leg ulcer treatment and raises an important question: should cardiac optimisation be a greater consideration in the care of patients with leg ulcers? The prevailing emphasis on compression therapy may benefit from reassessment, with particular attention to the role of cardiac function in wound healing.