Swollen ankles may be the presenting symptom in patients with cardiac failure.
Usually both ankles are affected equally, being worst at night and better in the morning.
The cardiac failure is usually biventricular, or may be due to right-sided failure, secondary to chronic lung disease.
With increasingly severe cardiac failure, the oedema advances up the thighs, genitalia and abdomen.
There are usually other signs of cardiac disease.
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