8. Swelling in the Legs
The big worries: An accumulation of fluid (called edema) in the extremities can be caused by a number of conditions, but the one that most concerns doctors is heart failure, when the heart cannot pump as much blood as the body needs. When that happens, blood backs up in the veins, causing fluid to accumulate in the body's tissues. "Swelling of the legs, especially if it is persistent, should never be ignored," says Gordon F. Tomaselli, M.D., director of the division of cardiology at the Johns Hopkins University School of Medicine in Baltimore. Heart failure is suspected when both legs are affected and the patient also has shortness of breath, fatigue and chest tightness.
What else it might be: A vein problem known as venous insufficiency can also cause swelling. Normally, valves in the leg veins keep blood flowing back to the heart, but in those with venous insufficiency, these valves are weakened, causing a backup of blood. "If valves are the problem, swelling usually goes away when you lie down," Tomaselli says. Compression stockings can help. Swelling can also result from hypothyroidism (not enough thyroid hormone).
9. Sudden or severe abdominal pain
The big worries: Sudden abdominal pain could signal that an aortic aneurysm — a bulge that develops in the aorta, frequently in the abdominal area — has ruptured. "If the aneurysm ruptures, the pain tends to be sudden and severe and typically centralized around the belly button," says Richard Desi, M.D., a gastroenterologist with Mercy Medical Center in Baltimore. Alternatively, sudden pain can indicate a perforated viscus (a hole in the stomach, intestine or other hollow organ), often due to an ulcer. Intestinal ischemia, which happens when blood flow to the intestines slows or stops, starving tissues of oxygen, can be a culprit, too. "It's more common in older, sicker patients who have heart failure or atrial fibrillation," says Brian Putka, M.D., a gastroenterologist with the Cleveland Clinic. Each of these conditions is life threatening, requiring emergency surgery.
What else it might be: Abdominal pain is frequently due to gallstones, which are hard, pebblelike deposits that get lodged in a gallbladder duct, resulting in sharp pain as well as nausea and vomiting. Diverticulitis — inflammation or infection in small pouches of the large intestine — can be another cause of sudden, severe pain, along with changes in bowel habits, fever and nausea. Although irritable bowel syndrome can trigger painful spasms in the colon, the pain tends to come and go over time and may also cause constipation, diarrhea or alternating bouts of both. Appendicitis is a less likely candidate for sudden abdominal pain in those over 50, as the condition is less common with age. When it does occur, however, expect gradually worsening pain in the right-lower quadrant of the abdomen.
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