Presentation
Compared with the estimated prevalence of incidental ovarian venous insufficiency of 10-47%, this suggests that only a minority of incompetent ovarian veins will present with clinically detectable lower limb venous insufficiency. [ncbi.nlm.nih.gov]
The correlations among the Leg Function component scores and SF-36 scales are presented in Table 1. [o-wm.com]
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]
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]
Entire Body System
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Collapse
Due to its thicker wall, a collapsed balloon that contains less fluid is more difficult to break than one distended with water. [woundcareadvisor.com]
Excess fat compresses and tries to collapse the vein. [podiatrytoday.com]
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Malnutrition
Also determine if the patient has comorbidities that may exacerbate CVI, including PAD, renal failure, venous thrombosis, lymphedema, diabetes mellitus, heart failure, or malnutrition. (See CVI risk factors by clicking the PDF icon above .) [woundcareadvisor.com]
Gastrointestinal
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Abdominal Pain
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]
Musculoskeletal
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Arthritis
Some of the other causes of leg pain include bone or joint disorders, low back problems such as arthritis or disc degeneration with compression of nerves, neuropathy, infection, arterial insufficiency (blockage of arteries carrying blood to the legs), [tennesseeveincare.com]
Other common medical conditions included depression (n 35), hypertension (n 32), arthritis (n 26), hepatitis C (n 25), bronchitis (n 20), and peripheral neuropathies (n 16). None of the participants had vascular lesions associated with hepatitis C. [o-wm.com]
An accurate history and physical examination with special reference to venous and arterial disease, diabetes and rheumatoid arthritis is performed in all patients. [anzsvs.org.au]
[…] ulcers, or stasis ulcers, account for 80 percent of lower extremity ulcerations. 1 Less common etiologies for lower extremity ulcerations include arterial insufficiency; prolonged pressure; diabetic neuropathy; and systemic illness such as rheumatoid arthritis [aafp.org]
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Musculoskeletal Pain
Two common types of pain for patients with HIV disease are musculoskeletal pain and peripheral neuropathy. Pain can impair functional mobility and limit physical activity. [o-wm.com]
Psychiatrical
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Social Isolation
Chronic leg ulcer impacts the quality of life in a number of ways such as reduced mobility, pain, unpleasant odor, sleep disturbances, social isolation, etc. [ncbi.nlm.nih.gov]
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Fear
The 10 most prevalent HIV-related symptoms were muscle aches, depression, thirst, weakness, fear/worries, fatigue, dry mouth, difficulty concentrating, gas/bloating, and painful joints. [o-wm.com]
Neurologic
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Difficulty Concentrating
The 10 most prevalent HIV-related symptoms were muscle aches, depression, thirst, weakness, fear/worries, fatigue, dry mouth, difficulty concentrating, gas/bloating, and painful joints. [o-wm.com]
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Absent Ankle Reflex
ankle reflexes, affecting the person’s ability to walk, work, and participate in activities. [o-wm.com]
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Polyneuropathy
[…] that occurs as a result of HIV/AIDS, some antiretroviral therapy, disorders such as alcoholism, diabetes mellitus, and nutritional problems. 17 Distal symmetrical polyneuropathy can cause non-painful paresthesias, abnormalities of pain and temperature [o-wm.com]
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Sleep Disturbance
Chronic leg ulcer impacts the quality of life in a number of ways such as reduced mobility, pain, unpleasant odor, sleep disturbances, social isolation, etc. [ncbi.nlm.nih.gov]
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Peripheral Neuropathy
Information about peripheral neuropathy was taken from the medical record and self-report. Physical assessment of peripheral neuropathy should be examined since it is prevalent in HIV-positive persons. [o-wm.com]
Treatment
Pain may be due to the disease, a side effect of treatment, or unrelated to the disease or treatment. Two common types of pain for patients with HIV disease are musculoskeletal pain and peripheral neuropathy. [o-wm.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]
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]
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]
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]
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]
Evidence of venous insufficiency may be minimal, so in some cases vascular evaluation (Doppler) may be required to confirm venous insufficiency as the etiology of the leg ulcer. [dermquest.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]
Study participants (1,054 persons with varicose veins and 259 without varicose veins) represented the seven clinical categories of the clinical, etiologic, anatomic, and pathophysiologic (CEAP) classification for venous insufficiency, ranging from having [o-wm.com]
Prevention
This principle is the basis for compression therapy in treating and preventing CVI ulcers. [woundcareadvisor.com]
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]