Chronic venous insufficiency is when veins get enlarged for diverse reasons, causing discomfort, pain, and even complications that can lead to death.
In this article, there is going to be an in-depth explanation of varicose veins, including its symptoms, complications, treatment, and more. Also, we are going to see some myths that surround this disease and when we should worry or not.
By reading this article, you will know about this widespread disease and what things you can do to cut this problem. Please continue reading to get the information you need directly from a doctor.
What is a vein?
A vein is a blood vessel that transports blood from different parts of the body to the heart. Usually, veins carry deoxygenated blood or blood without oxygen, but there are exceptions like the pulmonary veins, which bring blood with oxygen to the heart and, therefore, the whole body.
Superficial veins and deep veins are one of the ways doctors classify veins. Superficial veins do not go along any specific artery, and you can see them under the skin. Meanwhile, deep veins go along a specific artery, and you cannot see them since they are profound.
These blood vessels have valves that allow the blood to travel back to the heart by blocking the way the blood flows have to go backward. The valves are sort of a little door that closes for the blood not to return from where it just came. The veins are more elastic than arteries allowing them to carry more blood volume, but they can’t handle as much pressure.
What is a varicose vein?
A varicose vein is a dilated twisted vein that usually affects the lower extremities. These look blue, can be quite thick and cause discomfort to the person that has them. They are commonly caused by vein valves that no longer function properly, so the blood flow is allowed to go back down, making the veins stretch and tortuous.
This disease has several factors that intervene in making you more or less susceptible to having it. Some of them are genetic predisposition, dysfunctional valves, and debilitated vein walls, amongst others. Also, there are risks such as:
- family history of chronic venous insufficiency
- being female
- old age
- prolonged standing
Most of the times, varicose veins are asymptomatic, but in some people, they can present various symptoms like:
- Burning sensation
These are intensified at the end of the day and gets better when the patient elevate their legs, as it helps the blood flow back to the heart. Chronic venous insufficiency affects not only the superficial veins, but it also affects deep veins. When deep veins present this disease, there are more risks of complications.
Are varicose veins a health risk?
Although they can cause discomfort and aesthetical issues, vein doctors do not often associate it with significant health problems. Superficial varicose veins can be a health risk if they aggravate and form ulcers, making them prone to infections. Deep veins can present more significant health risks, like deep vein thrombosis in which blood clots are formed. If clots form in the varicose vein, it might need intervention from a vascular surgeon as it presents complications.
Also, heart failure is one of the causes of chronic venous insufficiency, making it essential to present other symptoms such as fatigue and palpitations. It is important to know the cause of the disease since that is what defines the treatment. If the source of the problem is congestive heart failure, the varicose veins get better when the heart failure receives medical treatment.
Do they get worse with age?
As previously mentioned, one of the risk factors that make you prone to have the disease is being of old age. That is because the valves after a long time of use become defective. There is a genetic predisposition for it to happen. This genetic predisposition includes debilitated blood vessel walls as it reduces the pressure the blood needs to go back.
Older people have more risks since they tend to be more obese or overweight than their younger counterparts. They also suffer more of heart failure and are more likely to work long hours standing up. The sum of all of these causes that as older you get, the worse varicose veins get.
Can it cause a stroke?
Strokes have two leading causes: Hemorrhagic or Ischemic problems. The hemorrhagic strokes are produced when an artery goes to the brain breaks; these are the worst kind. An ischemic stroke happens when the blood flow gets interrupted by a clot that comes from an artery. However, varicose veins cannot cause a stroke; instead, they can cause other life-threatening issues, although they are not common
When veins produce blood clots, it is called deep vein thrombosis (DVT). When clots happen in deeper veins, it can cause serious problems that can lead to losing a limb or even death. The obstruction of the affected vein halts the normal course of the blood flow, in the end, making the limb struggle with the lack of oxygen.
This situation requires the attention of a vascular specialist because, similarly, it is the root of pulmonary embolism, which occurs when a blood clot travels from the vein in the leg to the lungs occluding its arteries. It is a life-threatening condition, indeed.
But is chronic venous insufficiency dangerous?
Varicose veins are not usually dangerous, even though they have complications in some cases. When there is deep vein thrombosis, we know that it can cause a pulmonary embolism. These happen when the clots from the DVT get bigger and detach from the vein wall, heading to the lungs.
The blood clots get to the lung through the heart and then the pulmonary artery. The damage to the lungs depends on the size of the clot obstructing the artery. The bigger the clot is, the more significant the loss of tissue is, and the risk of death is higher.
If clots don’t detach from the blood vessel, it keeps growing, blocking the vein and the flux of oxygenated blood. The extremity affected presents swelling due to increased pressure making more blood go to the surrounding body tissues. Besides, the limb turns a dark blue or purple color depending on the severity of the disease.
What are the symptoms?
Varicose veins and spider veins, also called telangiectasia, are generally asymptomatic. When they cause symptoms like itching, pain, burning, and swelling is when the patients realize they have a vein problem.
The size of the visibly enlarged vein doesn’t always correlate with the extent of the symptoms the person has. Some people aren’t aware of their symptoms since the onset is progressive and slow. So, they only realize it when they get medical treatment.
The pain of these vein conditions can feel like a dull ache. Painful varicose veins are improved by walking or elevating the legs and are worsened by the menstrual cycle and oral contraceptives.
There is other conditions veins specialists associate to varicose veins such as superficial thrombophlebitis and leg ulcers.
Superficial thrombophlebitis happens when a clot forms on an external vein creating a node like a bulge. These are located mostly in the legs in damaged veins. They are painful, although usually resolve without any significant risks.
Skin ulcers on the leg occur after the member suffers an injury, big or small. When there are healthy veins, the tissue recovers quite quickly, but when there is a vein disease, it doesn’t. This causes a skin ulcer that hurts and has an unpleasant smell, resolves by getting treatment for the underlying disease.
How are varicose veins and spider veins diagnosed?
A doctor can provide diagnostic for this disease without problems through a clinical assessment. Evaluation of risk factors, symptoms, and signs in a physical examination can determine the presence of the disease. Certain signs can indicate the severity of the condition and even a possible cause such as:
- Presence of edema and if it is bilateral or unilateral (swelling of just one or both legs)
- The color of the skin
- Telangiectasia and varicose veins in the ankles in the form of a fan
- Presence of venous leg ulcers and skin infections
- Pelvic varicosities may indicate an obstruction at that level
Other forms of diagnosis, especially important in deep varicose veins, are imaging studies. These are useful in cases hard to diagnose and for treatment planning.
Duplex ultrasonography is the most used imaging tool for varicose veins, being noninvasive, painless, and straightforward. It can determine any incompetent vein junction, the extent of blood reflux, and can weigh on occult DVT.
Doctors use other imaging methods like MRI, computed tomography, or contrast venography when the duplex ultrasonography is inconclusive, or they need more information for precise treatment.
What are the treatment options for treating varicose veins?
We find two types of treatment for varicose veins: Conservative treatment and interventional treatment. Conservative treatment consists of:
- Compression: Some stockings and bandages bring relief to the person, but doctors lack evidence in their effectiveness as a definitive treatment.
- Elevation of the affected limb: Eases discomfort in most patients.
- Modification of lifestyle: By reducing hours standing up, wearing comfortable clothes, decreasing cardiovascular risks.
- Loss of weight: For patients who are overweight and obese, suffering from varicose veins.
Interventional treatment consists of
- Sclerotherapy: it entails injecting an irritating substance like hypertonic saline into the untreated varicose veins. These substances cause the walls of the vein to close, reducing the blood flowing in that vessel. It reduces swelling in the area, but it might need multiple injections in varicose veins to work.
- Laser therapy: Is a laser that performs over the skin for tiny superficial blood vessels. It works primarily for spider veins located in the face.
- Endovenous laser therapy: also called endovenous thermal ablation, goes inside the vein through a catheter and works for more prominent veins. This laser collapses the vein by causing irreversible thermal damage to its walls.
- Radiofrequency ablation: Works similarly as the endovenous laser therapy, but uses radio waves.
- Surgery: It has been widely used historically, but recent studies suggest other methods as treatment options. Updated techniques reduce blood loss, scarring, and complications, but it is still a topic on debate since its novelty.
Does ice help varicose veins?
Ice can provide comfort and lessen some symptoms since it reduces swelling in the area. It also can shrink the blood vessels helping with the flow of blood back to the heart. This only works momentarily when you apply the cold, making it a short term solution to a chronic problem.
Is walking good for varicose veins?
Yes, walking is good for varicose veins. The body’s mechanism to help the blood flow back up is through the contraction of leg muscles. As you walk, these muscles contract and relax, pressing the deep veins in the legs. When the veins get tighten up, the blood gets pumped back up, helping relieve the legs’ pressure.
However, if the disease is severe, walking might not be as useful since the reflux might be too much or the obstruction too significant to compensate.
What happens if varicose veins are left untreated?
Varicose veins, most of the time, only represent an aesthetical problem to the person and is not a health risk. If there are symptoms, signs, or risk factors that could alert a complication, treatment is necessary.
Moreover, if you have severe varicose veins and do not treat it, there is a small chance you can develop venous ulcers, deep venous thrombosis (DVT), superficial thrombophlebitis, amongst other complications.
It is also essential to get to the root of the condition since it can have diverse causes. For example, if heart failure is the source of the disease, you must go to a cardiologist or a physician. That way, you can prevent other issues associated with heart failure and eliminate the varicose veins.
What can you do if you are having symptoms of it?
This tool is a Chronic Venous Insufficiency symptoms checker. It has the most important signs, symptoms, and risk factors of this condition.
Therefore, it determines the likelihood of someone having or with high chances of developing chronic venous insufficiency. The most important thing is that this tool is free and would only take a few minutes.