Holton Community Hospital History

Heart Disease and Ulcers

Heart disease is a broad term which encompasses many conditions affecting the heart, including diseases of the heart muscle, blood vessel diseases, heart rhythm defects, and infections of the heart (1). One of the complications of heart disease is poor blood flow throughout the body. This can result in the development of non-healing wounds (2).

Two of the most common non-healing wounds that occur as a result of heart disease are arterial ulcers and venous ulcers, which commonly form on the legs and feet (2). Skin ulcers occur when small breaks in the skin from minor injuries do not heal and begin to increase in size and become infected (3).

Venous ulcers, the most common type of leg ulcers, occur when veins are not working properly. The majority of venous ulcers occur on the inside of the leg just above the ankle (4). Veins carry blood back to the heart from the rest of the body. Valves in the legs ensure the blood flows in one direction toward the heart. When these valves do not work properly, called venous insufficiency, blood pressure can increase in the legs when standing. This increased blood pressure in the legs can cause damage to the skin, leading to ulcers.

Decreasing the blood pressure in the leg by elevating the limb and compression therapy can help treat venous ulcers. Moreover, if tests confirm that specific veins are functioning very poorly, the veins can be destroyed by ablation or other methods to prevent high blood pressure in the leg (3, 5). If the signs of venous insufficiency are recognized before an ulcer forms, ulcers can be prevented by early treatment. Leg swelling, pain, tingling, and discoloration is a sign of increased blood pressure in the lower extremities. Compression stockings and leg elevation can prevent venous ulcers by decreasing blood pressure in the legs.

Arterial ulcers are caused when arteries are not functioning properly, most commonly on the feet. Arteries carry blood from the heart to the rest of the body. If blood circulation is compromised by blocked arteries, called peripheral arterial disease, arterial ulcers can form. These ulcers are very painful and usually cause swelling. Arterial ulcers may not heal with standard wound care alone— specialized care may be required to improve blood flow to the ulcer which will support the healing process. Surgery may be required to clear the blockage in the artery or to bypass the blockage (6).

Wound care is critically important for both arterial and venous ulcers. Infection is a great concern for non-healing chronic ulcers and must be treated with antibiotics. The appropriate wound dressings and treatment plan are critical in healing both chronic non-healing wounds.

  1. “Heart Disease.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 9 Feb. 2021, https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118.
  2. “Is a Heart-Related Chronic Wound Putting You at Risk of Amputation?” Southwestern Medical Center, 24 Feb. 2021, https://swmconline.com/news/heart-related-chronic-wounds.
  3. “Leg Ulcers.” Leg Ulcers – Vascular Society, https://www.vascularsociety.org.uk/patients/conditions/4/leg_ulcers.
  4. “Leg & Foot Ulcers: Causes, Diagnosis, Treatments & Prevention.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/17169-leg-and-foot-ulcers.
  5. “Venous Ulcers.” Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/venous-ulcers.
  6. “Arterial Ulcer.” Arterial Ulcer – Vascular Society, https://www.vascularsociety.org.uk/patients/conditions/12/arterial_ulcer.