This explains why congestive heart failure results in swollen ankles and feet. In this condition the heart is not strong enough to pump all the fluid returning to it from the veins. Swollen feet are an early sign which can be easily missed. Later on in the disease, fluid accumulates in the lungs making breathing difficult. The vessels providing circulation to the feet are among the smallest in the body.
Cold feet are an early sign of such diseases.
If a healthy foot's shoes fit improperly, a blister could develop that would prompt you to remove the offending shoe. The individual with a neurotrophic foot, however, would not even feel the blister. He would continue to wear the shoe, possibly causing extensive trauma to the foot. By the time he realized the extent of the problem, a deep infection may have set in. Such feet easily develop open sores known as ulcers, which heal with great difficulty.