Q My ankles often swell by the end of the day. I’m a machinist and spend most of the day stood up. I heard that may be a sign of heart failure. My nan died of this so I’m worried.

Marjorie – 54

A Although ankle swelling may be a sign of heart failure, you also tend to suffer breathlessness, particularly after walking a short distance. If you are able to stand all day and do your job, heart failure may be less likely as people with this usually get tired quite quickly. What you may be describing is something called dependent oedema. Simply put, the fluid in your legs is pumped back up to the heart by the muscles in your calves. But if you are stood on the spot, these are less active and the fluid also has to work against gravity. If you are concerned, it would be worth a visit to your GP, to examine your heart and lungs and either put your mind at ease, or organise tests as needed.

Q What is the difference between slapped cheek and scarlet fever? There has been a lot going round at my son’s nursery and I’m confused.

Sophie

A While both are fairly common in children of school age, the main difference is that slapped cheek is caused by a viral infection, while scarlet fever is a bacterial infection. The typical features of slapped cheek are, as the name states, cheeks that look very red. Although you may get a similar rash with scarlet fever, the tongue is affected and is described as “strawberry tongue” which may also have areas of whiteness. If you are concerned about either it is worth taking your child to see the GP. Slapped cheek does not need antibiotics and there is no need for the child to be off school, whereas scarlet fever does require antibiotics and the child should be off school until they have had 24 hours of antibiotics.

If you have a question for Dr Zak, you can email him at askdoctorzak@gmail.com, see his website, doctorzak.co.uk or find him on Twitter at @AskDoctorZak

Dr Uddin’s advice is provided in good faith and in accordance with currently accepted evidence. However, this content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of a GP, or other qualified health provider, regarding a medical condition.