By Majdi Ashchi, D.O., FACC, FSCAI, FSVMB, FABVM
Venous Insufficiency Overview
Venous Insufficiency is a condition in which the veins have difficulty sending blood from the legs back to the heart. This condition also goes by the name Varicose Veins. This problem occurs through a combination of weakened vein walls and faulty venous valves. Varicose veins are enlarged and twisted rope-like veins that appear near the surface of the skin. Any vein in the body can become varicose,however, the veins most affected are those in the legs, most notably the calved and inner thighs.
Under normal circumstances, one-way valves in the veins open and enable blood flow upward and toward the heart. If the walls are weak and the valves faulty, the blood will pool in the lower leg. This creates a pressure build that further weakens the veins causing them to become twisted (varicose), enlarged and painful. Over time, the increased pressure can cause additional valves to fail. This venous reflux, or venous insufficiency, leads to the development of varicose veins and spider veins. An example of painful varicose veins found elsewhere in the body is hemorrhoids. Hemorrhoids are simply varicose veins in the anus.
Who is Affected?
If you suffer from venous insufficiency, you are a member of a massive club with over 25 million members nationally. Half of all Americans over the age of 50 and two-thirds of women over 60 have this condition. Many factors can cause venous insufficiency, but the main factors are heredity, age, gender, pregnancy, lifestyle, and occupation.
Venous Insufficiency Signs and Symptoms
While in many cases, you can see venous disease on the skin surface, sometimes they are not visible. Varicose veins not being visible does not indicate what is happening underneath the surface. Therefore, symptoms often associated with veins include leg pain, heaviness, throbbing, swelling, itching, restlessness, fatigue, cramping, and burning. More prominent veins may cause small spider veins. Large ropey superficial varicose veins may be a symptom of something larger. In the medical world, considering varicose veins severe medical problems is not common, as bad as they may look and feel. However, large varicose veins may indicate a critical blockage in deeper veins, a potentially life-threatening condition called thrombosis. It is essential to meet with a doctor that specializes in treating venous disorders such as Shinsegae Heart & Vascular Center.
Treatment Options
Proper medical evaluation and treatment of varicose veins are essential. Because venous insufficiency is a progressive disease, symptoms will worsen if left untreated. The assessment includes a visual and physical examination of the legs and feet by a physician. The Physician will check for signs of skin breakdown. This includes but is not limited to inflammation, tender to touch areas, changes in skin color, ulcerations, etc. Your physician classifies these skin breakdowns on a scale from one to six. The criteria for this scale are clinical etiology, anatomical, and pathophysiological (CEAP). In most cases, your physician will order a particular ultrasound test called a Venous Insufficiency Duplex to determine if the valves in the veins are functioning correctly and to check for evidence of a blood clot. Based on the test findings, your physician will recommend a treatment plan to treat your venous disease in the best way.