If you’re wondering whether a heart problem can cause a cold sensation in the legs, your hunch is dead-on.

That cold feeling in your legs can be caused by congestive heart failure.

“Heart failure can certainly cause cold peripherals,” says Yaser Elnahar, MD, a cardiologist with Hunterdon Cardiovascular Associates in NJ.

“That is because of not sending enough blood to the organs. As the heart gets weaker in advanced heart failure, not enough blood is being pumped, and it will back up into the lungs.

“The result is poor circulation to many organs (brain = confusion, kidneys = kidney failure, GI tract = abdominal pain, peripherally = cold sensation).”

• The term “failure” refers to failure of the pumping system to work efficiently.

• CHF can be mild, moderate, severe or end stage.

A cold sensation in the legs has many possible causes, but what worries many people is if some kind of heart issue could be one of them.

But don’t go jumping to conclusions yet, especially if you don’t have the classic risk factors for congestive heart failure.

Why might heart failure cause cold legs?

It’s very logical: The body “knows” that not enough blood is circulating due to the impaired pumping system of the heart.

Hence, blood circulation is more concentrated to vital organs including the brain. This means less for the extremities: legs and feet. Less blood = more likelihood of a cold feeling.

A young and active, nonsmoking, non-overweight person with new-onset cold legs is not likely to have chronic or congestive heart failure.

Risk Factors for Congestive Heart Failure

• High blood pressure

• Coronary heart disease

• Diabetes

• Certain diabetes medications

• Other medications

• Smoking

• Drinking

• Obesity

• Sleep apnea

• Valvular cardiac problem

• Congenital heart defect

• Irregular heartbeats

• Older age

• Lack of exercise

Experiencing a sensation of cold – only in the legs, rather than the entire body – has numerous potential causes other than a heart problem.

“If you have poor circulation due to peripheral vascular disease, then you can have cold feet sensation,” says Dr. Elnahar.

Other Causes

• Rheumatoid arthritis

• Lupus

• Raynaud’s disease (though this more likely affects the feet and hands rather than legs)

Dr. Elnahar has publications in the Journal of Atrial Fibrillation, the Journal of Clinical Medicine and Research, Reports in Medical Imaging, and more.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.