Presentation
The condition can appear red or hot or edematous, but venous stasis dermatitis almost always presents bilaterally. Usually the left leg is more edematous, compared with the right leg. [mdedge.com]
The present study is the first to investigate the muscle pump effect in exercise hyperaemia in patients with venous insufficiency, who should be lacking an optimally functioning muscle pump. [ncbi.nlm.nih.gov]
If you are experiencing any of the symptoms described above, a simple ultrasound of your legs can determine if venous insufficiency is present or not. [hamiltonvein.com]
Granulation tissue and fibrin are often present in the ulcer base. [aafp.org]
Entire Body System
- Swelling
Pain may be caused by swelling, joint issues, and increased limb weight. SWELLING: CVI swelling usually occurs in the ankles and lower legs and is generally similar in both legs. [lymphnotes.com]
Even if you have surgery, you may still need to wear compression to keep your legs from swelling. [healogics.com]
Treatments Chronic Venous Insufficiency The goals of treatment are to reduce swelling and improve the return of blood to the heart. [surgery.ucsf.edu]
The most common early symptom of venous insufficiency is chronically swollen ankles; the feet and calves may also swell. [nyp.org]
Sometimes, you may need X-rays or specific scans to check for other causes of your leg swelling. Continued Treatment The main goal is to stop swelling and prevent leg ulcers. [webmd.com]
- Pain
The Leg Pain Questionnaire was adapted from an American Pain Society questionnaire. 41 Participants were asked how much pain they were currently having in their legs, worst leg pain in 24 hours, and average leg pain in 24 hours. [o-wm.com]
With PAD, patients may report pain on exercise (claudication), pain with elevation (nocturnal pain), or constant pain (resting pain). [woundcareadvisor.com]
Hot weather can incite leg pain and while walking, some patients describe pain in the first few steps that slowly lessens with movement. [theveindoctors.com]
Pain or tenderness in legs is not a normal condition. One of the most common causes of pain in the lower extremity is venous insufficiency, a condition in which the veins stretch over time and the one-way valves in the veins fail. [tennesseeveincare.com]
Tiny Veins, Major Pains Leg pain can be caused by many things, including dehydration and electrolyte imbalance. One common cause is venous insufficiency. To understand this condition, it is necessary to understand the function of veins. [ivein.com]
- Leg Swelling
For instance, the valve may become more displaced due to the increase in intraluminal fluid, which may in turn worsen hypertension and cause an increase in leg swelling. [woundcareadvisor.com]
Do you have swollen legs? Leg Swelling Related to Fluid Buildup Leg swelling caused by the retention of fluid in leg tissues is known as peripheral edema. [cardiologyconsultantsorlando.com]
leg swelling and leakage of blood and fluids from the veins. [vasculardoc.com]
Sometimes, you may need X-rays or specific scans to check for other causes of your leg swelling. Continued Treatment The main goal is to stop swelling and prevent leg ulcers. [webmd.com]
Pain may be caused by swelling, joint issues, and increased limb weight. SWELLING: CVI swelling usually occurs in the ankles and lower legs and is generally similar in both legs. [lymphnotes.com]
- Inflammation
When the blood stagnates, proteins leak out of the veins into the tissues—which may cause irritation and inflammation of the skin. The inflammation and irritation of the skin are precursors of an ulcer. [healthbeat.crozerkeystone.org]
This causes inflammation, especially when lacking antioxidants in the blood. [wellnessresources.com]
Chronic Venous Insufficiency or “CVI” is a condition in which the backward flow of blood within the veins or venous reflux can lead to tissue damage, inflammation or venous hypertension. [skinandvein.com]
[…] of the veins (known as phlebitis ) chronic constipation and in rare cases, tumors Complications of venous insufficiency include: pain inflammation and swelling skin ulcers bleeding when veins close to the surface of the skin burst blood clots, which [radiologyinfo.org]
In more severe cases, they can also lead to phlebitis — the swelling or inflammation of veins — or blood clots and skin ulcers. With many available treatments including non-invasive laser procedures, varicose veins can be safely removed. [affinityhealth.org]
- Weakness
Blood clots and weak leg muscles due to poor ambulation can also contribute to the development of venous insufficiency. [westlakedermatology.com]
In some cases, weakness in the leg muscles that squeeze blood forward can also contribute to venous insufficiency. Venous insufficiency is more common in women than in men. [healthline.com]
In some situations, weakness in the leg muscles that push blood forward can also add to venous insufficiency. Venous insufficiency is more frequent in women than in men. It is also more likely to develop in adults over 50 years old. [modernheartandvascular.com]
Some people may be born with weak valves. Weak valves run in some families. Another cause of CVI can be a problem with the calf muscle. If your muscles are getting weak, they may not be working well enough to help push blood back to the heart. [summitmedicalgroup.com]
Gastrointestinal
- Nausea
Symptom increases were most commonly due to diarrhea (32%), muscle/abdominal pain and/or headache (37%), weakness/fatigue (20%), peripheral neuropathy (20%), dermatological problems (eg, rash/itch — 15%), and nausea (15%). 5,6 Fleming and colleagues used [o-wm.com]
The most common side effects are itching, nausea, heartburn, headache, and dizziness. Most studies show no difference when compared to placebo. [lymphedemapeople.com]
[…] adjunctive treatment for venous ulcers when added to compression therapy. 31, 40 Pentoxifylline may also be useful as monotherapy in patients who are unable to tolerate compression bandaging. 31 The most common adverse effects are gastrointestinal (e.g., nausea [aafp.org]
Cardiovascular
- Venous Insufficiency
OBJECTIVE: The correlation between ovarian venous insufficiency and lower limb venous insufficiency remains poorly understood. [ncbi.nlm.nih.gov]
September 21, 2022 resiri No Comments Venous insufficiency usually refers to lower extremity swelling, trophic skin changes, and discomfort secondary to venous hypertension. Chronic venous insufficiency is a prevalent pathological process. [modernheartandvascular.com]
If left untreated, venous insufficiency leads to leg ulcers and potentially deadly blood clots. What is Venous Insufficiency (or Vein Reflux)? Venous Insufficiency is a serious disease of the veins that originates in the leg veins. [tampavascularsurgeon.com]
Causes of venous insufficiency The risk of developing venous insufficiency rises with increasing age. Women are far more often affected than men. [mediuk.co.uk]
- Thrombosis
Pain or tenderness in legs may also be the result of clotting (thrombosis) in the veins. [tennesseeveincare.com]
Valves in the vein may become damaged after the development of deep vein thrombosis (DVT). [saringer.com]
Those who are prone to high blood pressure are at even greater risk for obvious reasons, as are those with a history of circulatory problems such as deep vein thrombosis, defective valves, or phlebitis (and inflammation of the walls of the veins.) [orthosleeve.com]
If the acute thrombosis involves one or more of the one-way valves, as the obstructing thrombosis opens up within the vein’s lumen, permanent valvular damage may occur, leading to post-thrombotic syndrome—a form of CVI. [woundcareadvisor.com]
In more advanced cases, or cases where deep vein thrombosis has occurred, surgical intervention may be necessary to close or remove problem veins. [disability-benefits-help.org]
- Vein Disorder
In fact, more people lose work time from vein disorders than from artery disease. By the age of 50, nearly 40% of women and 20% of men have significant leg vein problems. Spider veins occur much more frequently in women. [vascularcures.org]
The original approach to vein ligation for superficial vein disorders involved removal of the entire GSV system; this approach has largely been supplanted by the stab evulsion technique. [emedicine.medscape.com]
A clot in a deep vein can move through the bloodstream resulting in embolism. Many factors contribute to DVT risk including inherited disorders, certain medications or vein injuries. [veinhealthcarecenter.com]
Skin
- Ulcer
One study of 600 patients with CVI ulcers revealed that 50% had these ulcers for 7 to 9 months, 8% to 34% had them for more than 5 years, and 75% had recurrent ulcers. [woundcareadvisor.com]
The site and size of the ulcer, the edge of the ulcer and the base of the ulcer are particularly important in deciding what sort of ulcer is present. [anzsvs.org.au]
[…] of venous ulcers. [aafp.org]
Venous Insufficiency Ulceration/Stasis Ulcer Stasis ulcers are the most common cause of leg ulceration. [dermquest.com]
Venous Skin Ulcer - Topic Overview. WebMD. http://www.webmd.com/skin-problems-and-treatments/tc/venous-skin-ulcer-t.... Updated August 21, 2015. Accessed July 12, 2017. London Health Sciences Centre. Venous Stasis & Arterial Ulcer Comparison. [woundsource.com]
- Skin Discoloration
In more severe cases, venous insufficiency can cause skin discoloration and ulceration which may be very difficult to treat. One percent of adults over age 60 have chronic ulceration. People without visible varicose veins can still have symptoms. [inovaheart.org]
Symptoms of Venous Insufficiency Typical lower extremity symptoms many patients experience include: Swelling Aching, burning, throbbing, cramping, or other discomfort Skin discoloration, itching, or eczema Varicose veins Skin ulcers Risk Factors for Developing [westlakedermatology.com]
discolorations White atrophy Dermatoliposclerosis Dermatitis (skin problems) Dry or weeping eczema Venous leg ulcer (open wound) Acute manifestations of venous disease are serious disorders such as superficial (SVT) or deep venous thrombosis (DVT). [sigvaris.com]
This condition can cause severe leg swelling, varicose veins, skin discoloration and much more, so it's important to seek treatment early to prevent real damage to your legs. [footsmart.com]
Skin discoloration : Persistent interruption in blood flow can eventually lead to discoloration due to lack of blood nutrients in the skin. [veinsofhouston.com]
- Eczema
Symptoms of Venous Insufficiency Typical lower extremity symptoms many patients experience include: Swelling Aching, burning, throbbing, cramping, or other discomfort Skin discoloration, itching, or eczema Varicose veins Skin ulcers Risk Factors for Developing [westlakedermatology.com]
[…] symptoms of venous disease or Chronic Venous Disorders (CVD) include: Feeling of swelling Feeling of heaviness in the legs Pain or cramps in the calves Skin discolorations White atrophy Dermatoliposclerosis Dermatitis (skin problems) Dry or weeping eczema [sigvaris.com]
Other skin changes in the lower leg that commonly occur include discoloration, eczema, scarring or hard, thickened skin and ulceration. [vascularcures.org]
( L23 - L25 ) dry skin dermatitis ( L85.3 ) small plaque parapsoriasis ( L41.3 ) stasis dermatitis ( I87.2 ) Dermatitis (eczematous) L30.9 ICD-10-CM Diagnosis Code L30.9 Dermatitis, unspecified 2016 2017 2018 2019 Billable/Specific Code stasis I87.2 Eczema [icd10data.com]
- Pruritus
Pruritus may accompany skin changes. [merckmanuals.com]
[…] ulcers often are depressed, fearful, socially isolated, and angry. 23,27 In addition, they experience disturbed sleep, impaired mobility, and financial concerns. 22,27 Lack of employment negatively affects quality of life. 30 Other reported symptoms were pruritus [o-wm.com]
- Skin Disease
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]
Musculoskeletal
- Leg Pain
Leg pain associated with CVI is the result of pressure buildup and swelling caused by the pooling or collection of blood in the legs. [theveindoctors.com]
Leg Pain If you’re a professional athlete or weekend warrior, you’ll know how important leg health is to your activity of choice. [ivein.com]
The Leg Pain Questionnaire was adapted from an American Pain Society questionnaire. 41 Participants were asked how much pain they were currently having in their legs, worst leg pain in 24 hours, and average leg pain in 24 hours. [o-wm.com]
Fibromyalgia often is diagnosed for leg pain which turns out to be due to venous insufficiency. Too often, patients with soft tissue pain or tenderness of the legs are misdiagnosed if they do not have large, obvious varicose veins of the legs. [tennesseeveincare.com]
Venous hypertension syndrome – leg pain when standing and leg pain when the leg is dangled. Leg elevation relieves the pain. Patients are often young women. There are no other signs or symptoms. [angiologist.com]
- Leg Cramp
April 22, 2014 / in Questions and Answers, Vein Conditions / by La Jolla Vein Care Leg cramps occurring at night (nocturnal leg cramps) are a common symptom of venous disease. [lajollaveincare.com]
[…] 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]
Venous insufficiency symptoms You could be suffering from venous insufficiency if you are experiencing any of the following symptoms: Leg cramps Restless legs at night Heaviness, tired, and achy legs Feeling of tightness in the calves Pain in the legs [tampavascularsurgeon.com]
Symptoms Signs and Symptoms of Venous Insufficiency / Iliocaval Compression Syndrome 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 [cardiologyconsultantsorlando.com]
[…] 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]
- Muscle Spasm
spasms (charley horse) The symptoms of chronic venous insufficiency may seem like other health conditions. [hopkinsmedicine.org]
Treatment
Symptoms and signs of CVI The problems associated with CVI do not disappear without treatment and the complexity of treatment increases as the disease progresses. [lymphedemablog.com]
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]
Secondly, treatments will focus on the original cause of the CVI. These treatments are broken into two categories. First are the non-surgical treatments. [lymphedemapeople.com]
Venography, though often diagnostic, is invasive and often used only if treatment is being planned. Treatment for chronic venous insufficiency Treatment for venous insufficiency depends on the cause and extent of the condition. [angiologist.com]
According to sex, the disease was found to have greater effect on women (especially on their emotional condition) and women had more faith in successful treatment, while correlation with age was nonsignificant. [ncbi.nlm.nih.gov]
Prognosis
Prognosis The prognosis is variable and depends on the progression of disease, extent of damage, and the presence of other diseases, which may affect the cardiovascular system. [medical-dictionary.thefreedictionary.com]
Outlook (Prognosis) Chronic venous insufficiency tends to get worse over time. However, it can be managed if treatment is started in the early stages. [baptistjax.com]
Prognosis Venous Insufficiency Venous insufficiency is not a benign condition, and it involves enormous morbidity. Without correction, the condition is progressive. [modernheartandvascular.com]
Etiology
Classification C- clinical manifestation E- etiologic factors A- anatomic distribution P- pathophysiologic dysfunction Severity Scoring 1. Number of anatomic segments affected 2. Grading of signs and symptoms 3. [jobst.com]
Bottom line: You need to consider the etiology. That's where my statement "it's not an ulcer with a varicose vein, it's a varicose vein with an ulcer" comes into play. [aapc.com]
We must identify the underlying etiology in order to help with the treatment protocol. Stay tuned for my next blog post on treatment options for patient with venous insufficiency. References 1. Callam MJ. Epidemiology of varicose veins. [podiatrytoday.com]
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]
Figure 1: Venous ulcer with obesity as cofactor Figure 2: Large superficial venous ulcer Etiology Any condition that causes blood to pool in the veins of the leg is a potential cause of venous ulcers, including varicose veins, deep vein thrombosis, or [woundsource.com]
Epidemiology
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]
Epidemiology of varicose veins. Br J Surg. 1994; 81(2):167–73. 2. Fowkes FG, Evans CJ, Lee AJ. Prevalence and risk factors of chronic venous insufficiency. Angiology. 2001; 52(Suppl1):S5–15. 3. Krajcar J, Radakovic B, Stefanic L. [podiatrytoday.com]
Contraceptive medication use, hypertension, previous leg injuries, and low intake of cellulose fibbers have also been considered. [5] Epidemiology United States statistics CVI is a significant public health problem in the United States. [emedicine.medscape.com]
Venous ulcer: epidemiology, physiopathology, diagnosis and treatment. Int J Dermatol. 2005;44(6):449–456. 4. Callam MJ, Harper DR, Dale JJ, Ruckley CV. Chronic ulcer of the leg: clinical history. Br Med J (Clin Res Ed). 1987;294(6584):1389–1391. 5. [aafp.org]
Pathophysiology
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]
PATHOPHYSIOLOGIC CLASSIFICATION Basic CEAP: Pr: reflux. Po: obstruction. Pr,o: reflux and obstruction. Pn: no venous pathophysiology identifiable. [jobst.com]
Pathophysiology of venous insufficiency during pregnancy. Acta Med Croatica. 1998; 52(1):65–69. [podiatrytoday.com]
B 32 Pathophysiology The pathophysiology of venous ulcers is not entirely clear. Venous incompetence and associated venous hypertension are thought to be the primary mechanisms for ulcer formation. [aafp.org]
Filaria Journal -------------------------------------------------------- The aetiology and pathophysiology of chronic venous insufficiency and leg ulcers http://www.ucl.ac.uk/~rehk999/cvi1.htm -------------------------------------------------------- Pathophysiology [lymphedemapeople.com]
Prevention
There are special valves in veins designed to prevent back-flow. Venous insufficiency prevents successful transportation of blood back to the heart due to impaired valves or other obstruction preventing proper vein function. [veinsofhouston.com]
[…] your weight is one way to prevent varicose veins. [coastalvascularcenter.com]
There is less pressure to pump the blood up the veins to the heart and to prevent the blood from flowing back in the wrong direction. Numerous one-way valves in the veins prevent the backflow. [healthbeat.crozerkeystone.org]
The goals of treatment are to reduce the pooling of blood and prevent ulcers. [cleaverderm.com]
Again, the key to prevention of the late sequelae of DVT and thrombophlebitis, called chronic venous insufficiency, is wearing supportive hose. [footsmart.com]