Presentation
The average confidence was only 1.44 in patients presenting without symptoms but physical signs. [evtoday.com]
The first presentation is a reddish-brown skin discoloration, typically of the medial ankle. As the disease progresses, eczematous changes may be present, with weeping patches and plaques. [netce.com]
Clinical presentation Pelvic venous disease classically presents with a constellation of symptoms that have been described as pelvic congestion syndrome. [veindirectory.org]
Granulation tissue and fibrin are often present in the ulcer base. [aafp.org]
Venous valves are most prevalent in the distal lower extremity, whereas as one proceeds proximally, the number of valves decreases to the point that in the superior and inferior vena cava, no valves are present. . 6. [slideshare.net]
Entire Body System
- Leg Edema
Leg edema tends to be unilateral or asymmetric; bilateral symmetric edema is more likely to result from a systemic disorder (eg, heart failure, hypoalbuminemia) or certain drugs (eg, calcium channel blockers). [merckmanuals.com]
Lower-extremity pitting edema is common in patients with venous insufficiency. [emedicine.medscape.com]
Discussion Patients suffering from CVD, causing such as leg ulcers, edema, venous stasis, venous hypertension, etc., are demonstrate worse QoL. [intechopen.com]
- Severe Pain
Severe pain and discomfort are typical of these conditions, particularly in the lower leg (calf & ankle) where proximity of nerves exacerbates the situation. [thepremierveincenter.com]
Severe pain and discomfort are typical of these conditions, particularly in the calf and ankle. Open ulcers do not heal if the ankle is swollen. [vascularcenterwf.com]
It manifests itself through marked redness, swelling, a strong feeling of warmth and severe pain along the vein. [medi.de]
- Localized Pain
[…] chronic inflammation and fibrosis of skin and subcutaneous tissues of lower leg Painful, indurated, and hardened skin Atrophie blanche : White, coin- to palm-sized atrophic plaques due to absent capillaries in the fibrotic tissue. [amboss.com]
- Lower Extremity Pain
In addition to poor cosmesis, CVI can lead to chronic life-threatening infections of the lower extremities. Pain, especially after ambulation, is a hallmark of the disease. [emedicine.medscape.com]
- Limb Pain
There are some issues that can examined by the AVVQ such as social situation and physical symptoms including pain, edema in lower limbs, venous ulcers, using compression therapy and the impact of varicose veins on routine activities. [intechopen.com]
Gastrointestinal
- Overeating
[…] bony prominences, particularly the gaiter area (over the medial malleolus). [aafp.org]
A support stocking is worn over the dressing to hold the dressing in place and improve circulation in the leg and foot. [surgery.ucsf.edu]
Over time, this increased pressure can cause additional valves to fail. If left untreated, it can lead to leg pain, swelling, ulcers, and other health problems. [veinhealthcarecenter.com]
Varicose veins affect one out of two people over the age of 50, and women are particularly susceptible. [pedesorangecounty.com]
Over time, CVI may result in varicose veins, swelling and discoloration of the legs, itching and the development of ulcers near the ankles. Vein problems are among the most common chronic conditions in North America. [vascularcures.org]
Skin
- Hyperpigmentation
Venous stasis dermatitis consists of reddish brown hyperpigmentation, induration, venous ectasia, lipodermatosclerosis (fibrosing subcutaneous panniculitis), and venous stasis ulcers. [merckmanuals.com]
CVI frequently causes Inflammatory skin disease (stasis dermatitis) on the lower extremities of patients with CVI, followed by development of reddish-brown skin discoloration and hyperpigmentation (hemosiderin stains). [lymphnotes.com]
Physical findings include swelling, varicose veins, and areas of hyperpigmentation [ 6 ]. Hyperpigmentation is due to the deposits of hemosiderin in the skin—byproducts of melanin and erythrocyte breakdown [ 11 ]. [academic.oup.com]
Signs and symptoms [ edit ] Chronic venous insufficiency Signs and symptoms of CVI in the leg include the following: Varicose veins Itching ( pruritus ) Hyperpigmentation Phlebetic lymphedema [5] Chronic swelling of the legs and ankles Venous ulceration [en.wikipedia.org]
The periwound skin may be macerated with crusting and scaling, sometimes accompanied by hyperpigmentation. 3 Vascular studies are used to assist in the diagnosis of CVD with or without ulcer, and venous duplex ultrasonography is the most reliable noninvasive [journals.lww.com]
- Skin Discoloration
Over time, improper blood flow can lead to a variety of problems including blood clots, swollen veins, leg pain, skin discoloration and open sores. [scripps.org]
Painful ulcers may form on the skin near varicose veins, particularly near the ankles. A discolored spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you've developed an ulcer. Blood clots. [mayoclinic.org]
CVI frequently causes Inflammatory skin disease (stasis dermatitis) on the lower extremities of patients with CVI, followed by development of reddish-brown skin discoloration and hyperpigmentation (hemosiderin stains). [lymphnotes.com]
[…] the skin spider veins (so called teleangiectasia) swelling skin discolorations – dark brown discolorations especially in the ankle area indolent wounds and ulcers eczema venostaticum Stages of advancement of venous insufficiency of the lower limbs 3 Diagnosis [klinikaflebologii.pl]
Lipodermatosclerosis presents as A) atrophic areas of white or pale skin. B) an open wound on the lower extremities. C) brownish or grayish discoloration of the skin. D) hard, waxy, hyperpigmented tissue with swelling of the surrounding areas. [netce.com]
Musculoskeletal
- Leg Pain
Pain or other symptoms include: Dull aching, heaviness, or cramping in legs Itching and tingling Pain that gets worse when standing Pain that gets better when legs are raised Skin changes in the legs include: Swelling of the legs Irritated or cracked [medlineplus.gov]
Leg pain, dull aching, heaviness or cramping. [surgery.ucsf.edu]
We recommend that you contact the vascular surgeon, if there are these signs of venous disease: Quick fatigue and sensation of heaviness in the legs; Leg pain after prolonged sitting or standing; Legs swelling after a work day; Contrast subcutaneous venous [gkklinika.com]
Over time, improper blood flow can lead to a variety of problems including blood clots, swollen veins, leg pain, skin discoloration and open sores. [scripps.org]
Symptoms of chronic venous insufficiency may include: Swelling in your legs or ankles Tight feeling in your calves or itchy, painful legs Pain when walking that stops when you rest Brown-colored skin, often near the ankles Varicose veins Leg ulcers that [hopkinsmedicine.org]
- Muscle Cramp
However, other cases of varicose veins are associated with itching, pain, a feeling of lower extremity heaviness, and muscle cramping. [massgeneral.org]
But improving your circulation and muscle tone may reduce your risk of developing varicose veins or getting additional ones. [mayoclinic.org]
When symptoms are present the most common are heaviness or fullness, aching, restlessness, tiredness, fatigue, pain, throbbing, burning, itching and muscle cramping. [vascularcures.org]
A) Toe muscle pump B) Calf muscle pump C) Foot muscle pump D) Thigh muscle pump AN OVERVIEW OF LOWER EXTREMITY VENOUS ANATOMY Among these three pumps, the calf pump is the most important and is responsible for the greatest pressures [6]. [netce.com]
As we emphasized, CVI is a chronic disease seen with the many symptoms ranging from aching of the legs, varicose veins, telangiectasia, muscle cramps, swelling, pruritus, fatigue, throbbing, itching of the skin, to sense of heaviness in lower limbs [ [intechopen.com]
- Leg Cramp
[…] are sometimes hard to treat Having an uncomfortable feeling in your legs and an urge to move your legs (restless legs syndrome) Painful leg cramps or muscle spasms (charley horse) The symptoms of chronic venous insufficiency may seem like other health [hopkinsmedicine.org]
[…] without moving Symptoms of venous insufficiency include: swelling of the legs or ankles ( edema ) pain that gets worse when you stand and gets better when you raise your legs leg cramps aching, throbbing, or a feeling of heaviness in your legs itchy [healthline.com]
[…] muscles after many hours of standing or sitting, relieved after rest or placing the legs higher bothering cramps of the lower legs, especially at night itchiness restless legs syndrome pain along the vein 2 What can be observed on the legs of patients [klinikaflebologii.pl]
Cramps in the legs have several causes, but cramps that start with exercise and stop with rest most likely are due to intermittent claudication. [emedicinehealth.com]
- Muscle Spasm
spasms (charley horse) The symptoms of chronic venous insufficiency may seem like other health conditions. [hopkinsmedicine.org]
- Ankle Pain
Signs and symptoms of venous disease Most forms of vein disease cause the following symptoms, often present in the lower legs: Bulging, twisted veins that are easily visible through the skin Swollen legs and ankles Pain, aching, or a heavy feeling in [scripps.org]
Workup
Additionally, even when the pelvic source is recognized, the diagnostic workup and best method of treatment may be unknown to many clinicians. [veindirectory.org]
The absence of a pulse in the legs or the arms will immediately result in a workup to rule out peripheral vascular disease. [emedicinehealth.com]
Treatment
Learn about your options for treatment of venous disease by visiting the Treatment Options page. Expand Your Knowledge: DVT that results in an embolism can cause the immediate onset of extreme pain. [veinhealthcarecenter.com]
"Most health care professionals don't understand the pathophysiology of the disease, and that often results in delays in getting the proper treatment." [ucsfhealth.org]
These percutaneous treatments can be performed in an office with excellent results and minimal pain. Thermal treatments do require tumescent anesthesia to limit pain and thermal injury of adjacent structures such as skin and nerves. [vasculardiseasemanagement.com]
Treatment CVI treatment (in the absence of lymphedema) may include: Compression stockings to improve blood flow in your legs, help prevent leg swelling and, to a lesser extent, blood clots. Skin care treatments including drugs or medicines. [lymphnotes.com]
If this treatment solves the patient’s problems, then no additional treatment or workup is required. If however, the patient has persistent symptoms or early recurrence of varicosities, then treatment of the upper component should be considered. [veindirectory.org]
Prognosis
[…] obstructed deep veins Treatment Complications Venous ulcers Definition : Chronic defects of the skin that do not heal spontaneously Etiology : usually caused by chronic venous insufficiency Clinical features Diagnostics Treatment Differential diagnosis Prognosis [amboss.com]
Prognosis Venous Insufficiency Venous insufficiency is not a benign condition, and it involves enormous morbidity. Without correction, the condition is progressive. [modernheartandvascular.com]
In men older than 50 years, the incidence is 20%, compared with 50% in similarly aged women. [10] Prognosis The syndromes of venous hypertension and reduced venous clearance are important causes of morbidity and disability in patients with varicose venous [emedicine.medscape.com]
Long-term prognosis for patients with chronic leg ulcers: a prospective cohort study. Eur J Vasc Endovasc Surg. 1997;13(5):500–508. 10. Samson RH, Showalter DP. Stockings and the prevention of recurrent venous ulcers. [aafp.org]
Etiology
Etiology Pelvic-derived lower extremity varicosities have many different etiologies. These etiologies can be split into two broad categories—venous reflux and venous obstruction. [veindirectory.org]
Etiology Risk factors for chronic venous disease Higher age and female sex (see “ Epidemiology ” above) Family history of venous disease Ligamentous laxity Sedentary lifestyle and prolonged standing Obesity Pregnancy Smoking Prior thrombosis ( postthrombotic [amboss.com]
OBJECTIVE: To test a new classification of chronic venous disease (CVD)--based on clinical, etiologic, anatomic, and pathophysiologic data (the CEAP system)--in a series of patients by using objective tests to establish all diagnoses. [ncbi.nlm.nih.gov]
Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. [aafp.org]
Epidemiology
The epidemiology of venous diseases. Phlebology 15(1):2–18. Augustin, M., F. Bross, E. Foldi, W. Vanscheidt, and I. Zschocke. 2005. [nap.edu]
Definition Epidemiology References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Epidemiology of Chronic Peripheral Venous Disease. In J.J. Bergan & N. Bunke-Paquette (Eds.), The Vein Book (pp. 27-36). New York, NY: Oxford University Press. 2. American Heart Association, SIR, Brand et al. [medtronicendovenous.com]
So far, there is no available epidemiologic data concerning chronic venous insufficiency of the legs (CCI) in Lithuania. Researches in Italy, Germany and England, show that chronic leg vein insufficiency affects about 15 percent of people aged 18+. [gkklinika.com]
Epidemiology Epidemiological studies have found that the incidence of venous ulcers increases with age and that such ulcers are associated with obesity, diabetes, heart failure, hypertension, renal disease, and rheumatoid arthritis [ 4, 8 ]. [academic.oup.com]
Pathophysiology
Reflux was the pathophysiologic problem in 86% of the total series and in 80% of ulcer cases. Similar relationships can be delineated for cases with varicose veins, edema, or skin changes. [ncbi.nlm.nih.gov]
Pathophysiology of chronic venous disease. UpToDate. Last updated April 12, 2012. www.uptodate.com/contents/pathophysiology-of-chronic-venous-disease?source=search_result&search=Pathophysiology+of+chronic+venous+disease &selectedTitle=1%7E127. [woundcareadvisor.com]
Chapter 2 presents the mechanism and magnitude of hemodynamic changes in acute deep vein thrombosis indicating their pathophysiological and clinical significance. [minervamedica.it]
Therefore, we first decided to begin giving information about the anatomy and pathophysiology of the disease. 2. [intechopen.com]
Prevention
Prevention There's no way to completely prevent varicose veins. But improving your circulation and muscle tone may reduce your risk of developing varicose veins or getting additional ones. [mayoclinic.org]
Preventing severe complications such as venous leg ulcers is key. Often recurs Even with very successful treatment, recurrence is common and you may need further care. [vascular.org]
The superficial system has no muscle pump to aid venous return but the valves normally prevent retrograde flow, particularly at sapheno-femoral and sapheno-popliteal junctions. [clinicalgate.com]
Progressive vein dilation eventually prevents the valve from closing properly resulting in reflux. Alternatively, a lack of competent valves can also cause dilation of the vein. [vascularcenterwf.com]