Causes of Leg Swelling and Potential Problems

Case Study: Patient Analysis

The patient presents with dyspnea (difficulty breathing) and unilateral left leg pain with swelling and erythema, all of which suggest an underlying cardiovascular and cardiopulmonary condition (Chizner, 2023). Given her history of recent airplane travel, oral contraceptive use, and systemic lupus erythematosus (SLE), a likely diagnosis is deep vein thrombosis (DVT) which has contributed to a pulmonary embolism (PE).

DVT is the formation of a blood clot, usually in the deep veins of the legs. Prolonged immobility during air travel, oral contraceptive use (which increases estrogen levels and clotting risk), and SLE (autoimmune disease associated with a hypercoagulable state) all increase the likelihood of DVT. The unilateral leg swelling, erythema, and pain support the diagnosis of DVT (Chizner, 2023). If the clot dislodges and travels to the lungs, it can cause a PE, which explains the patient’s dyspnea and increased respiratory rate. The elevated heart rate and mild fever may also be secondary signs of PE (Walke & Pohekar, 2021).

Ethnic and racial factors can be affecting this case. African American women with SLE have higher risks of cardiovascular complications, including thromboembolic events, compared to other racial groups (Garg et al., 2023). There may also be genetic predispositions related to clotting for different ethnic groups.

The interaction between these pathophysiologic processes will put the patient at greater risk. Her SLE induces a hypercoagulable state, and when combined with her use of oral contraceptives and prolonged immobility it further increases her likelihood of DVT. The DVT can then contribute to a life-threatening PE, affecting her cardiopulmonary system and causing the dyspnea she is experiencing. Due to the interaction of cardiovascular and pulmonary complications she requires prompt medical intervention so as to prevent further deterioration.