Varicose
Veins
Varicose
veins are enlarged veins that are visible through
the skin and may appear as blue or purple twisted,
knot-like cords. Varicose veins can occur anywhere
in the body, but are more commonly found on the
legs. Hemorrhoids, a type of varicose vein, can
appear during pregnancy around the anus or in
the vagina.
Spider
veins, a milder type of varicose veins, are smaller
than varicose veins and often look like a sunburst
or "spider web." They are red or blue
in color and are commonly found on the face and
legs, just under the surface of the skin.
Varicose
veins are caused by increased blood pressure inside
the superficial leg veins. Two main types of veins
are present in the legs. Superficial veins are
near the surface of the skin, whereas deep veins
are located in the muscle tissue. Varicose veins
occur in the superficial veins in the legs. In
contrast, deep veins lead to the vena cava, a
large vein that transports blood to the heart.
The
blood in the veins of the legs works against gravity
in order to return upwards to the heart. The blood
is moved up towards the heart by one-way valves
in the veins. When the leg muscles contract and
squeeze the deep veins, the valves inside the
veins open. When the leg muscles relax, the valves
close, preventing blood from flowing backward.
When
the one-way valves become weakened or damaged,
blood can collect in the veins, causing the veins
to become enlarged. Sitting or standing for long
periods can cause blood to pool in the leg veins,
increasing the pressure within the veins. In persons
who are prone to varicose veins, the veins can
stretch as a result of increased pressure. This
stretching of the veins may weaken the walls of
the veins and damage the valves. Thick varicose
veins or spider veins may result.
Other
factors that may lead to weakened vein valves
and the development of varicose veins include
obesity, aging, leg injury, pregnancy, smoking,
hormones, and heredity (being born with weak vein
valves). While varicose veins are not considered
a severe medical condition, they can be uncomfortable
and can lead to more serious problems such as
phlebitis (inflammation in the leg) or blood clot.
Varicose veins can also be a cosmetic concern
to some people.
Varicose
veins, because they occur in superficial veins,
are not generally linked to a serious condition
called deep vein thrombosis (DVT). However, with
severe varicose veins, there is a small increased
chance of developing DVT. DVT requires immediate
medical attention. Symptoms of DVT include sudden,
severe leg swelling and can result in blood clots
that travel to the brain or the heart.
The
following are the most common symptoms of varicose
veins. However, each individual may experience
symptoms differently. Symptoms may include:
- color changes in the
skin
- sores on the legs
- rash
- sensations in the legs,
such as a heavy feeling, burning, and/or aching
Severe
varicose veins may eventually produce long-term
mild swelling that can result in more serious
skin and tissue problems, such as ulcers and nonhealing
sores.
The
symptoms of varicose veins may resemble other
medical conditions or problems. Always consult
your physician for a diagnosis.
In the
US, as many as 40 million people have varicose
veins. The risk of varicose veins is strongly
related to age and gender. The following are suggested
risk factors for varicose veins:
- obesity
Obesity is a major risk factor for varicose
veins. Excessive weight increases the pressure
on the veins of the legs and aggravates the
condition.
- family history
Heredity is important in determining susceptibility
to varicose veins, but the specific factors
responsible for this have not been identified.
- inactivity
Prolonged standing or sitting increases pressure
in the veins.
- gender
Women are particularly susceptible to varicose
veins because of the influence of progesterone
on the veins and the effects of pregnancy.
- pregnancy
Pregnant women have an increased risk of developing
varicose veins due to the hormonal influences
of pregnancy on the veins, but the veins often
return to normal within one year of childbirth.
Women who have multiple pregnancies may develop
permanent varicose veins.
- age
Varicose veins usually affect people between
the ages of 30 and 70. With advancing age, the
elastic shell of the vein begins to weaken increasing
the chance that the vein will dilate.
A risk
factor is anything that may increase a person's
chance of developing a disease. It may be an activity,
such as smoking, diet, family history, or many
other things. Different diseases have different
risk factors.
Although
these risk factors increase a person's risk,
they do not necessarily cause the disease. Some
people with one or more risk factors never develop
the disease, while others develop disease and
have no known risk factors. But, knowing your
risk factors to any disease can help to guide
you into the appropriate actions, including changing
behaviors and being clinically monitored for the
disease.
In addition
to a complete medical history and physical examination,
diagnostic procedures for varicose veins may include
any, or a combination, of the following:
- duplex ultrasound
- a type of vascular ultrasound procedure done
to assess blood flow and the structure
of the leg veins. The term "duplex"
refers to the fact that two modes of ultrasound
are used - Doppler and B-mode. The B-mode transducer
(like a microphone) obtains an image of the
vessel being studied. The Doppler probe within
the transducer evaluates the velocity and direction
of blood flow in the vessel.
- color-flow imaging
(Also called triplex ultrasound.) - a procedure
similar to duplex ultrasound that uses color
to highlight the direction of blood flow. Vessels
in which blood is flowing are colored red for
flow in one direction and blue for flow in the
other, with a color scale that reflects the
speed of the flow.
- magnetic resonance
venography (MRV) - a diagnostic procedure that
uses a combination of a large magnet, radiofrequencies,
and a computer to produce detailed images of
organs and structures within the body. An MRV
uses magnetic resonance technology and intravenous
(IV) contrast dye to visualize the veins. Contrast
dye causes the blood vessels to appear opaque
on the x-ray image, allowing the physician to
visualize the blood vessels being evaluated.
MRV is useful in some cases because it can help
detect causes of leg pain other than vein problems.
Specific
treatment for varicose veins will be determined
by your physician based on:
- your age, overall health,
and medical history
- extent of the condition
- your signs and symptoms
- your tolerance of specific
medicines, procedures, or therapies
- expectations for the
course of the condition
- your opinion or preference
Medical
treatment may not be necessary if there are no
symptoms. However, varicose veins may sometimes
worsen without treatment. Treatment for varicose
veins involves both surgical and nonsurgical approaches.
Nonsurgical
methods for treating varicose veins include:
- elevation of the legs
You may be instructed to elevate your feet above
the level of your heart three or four times
a day for about 15 minutes at a time. If you
need to sit or stand for a long period of time,
flexing (bending) your legs occasionally can
help keep blood circulating. If you have mild
to moderate varicose veins, elevating your legs
can help reduce leg swelling and relieve other
symptoms.
- compression stockings
These elastic stockings squeeze or compress
the veins and prevent blood from flowing backward.
In addition, compression stockings may help
with healing of skin sores and prevention of
additional sores. Compression stockings are
effective in treating varicose veins if worn
daily and may prevent the need for more invasive
treatment.
- sclerotherapy
Sclerotherapy is the most common treatment for
both spider and varicose veins. This procedure
involves a saline or chemical solution that
is injected into the varicose veins that causes
them to harden so that they no longer fill with
blood. Blood that would normally return to the
heart through these veins returns to the heart
by way of other veins. The veins that received
the injection will eventually shrivel and disappear.
The scar tissue is absorbed by the body.
- laser treatment
Laser treatment is a type of treatment for varicose
veins. Until recently, laser treatment was mainly
used for treatment of spider veins on the face.
However, newer laser technology can now effectively
treat varicose veins as well. There are several
types of lasers that may be used to treat varicose
veins. The physician inserts a tiny fiber into
a varicose vein through a catheter. The fiber
sends out laser energy that destroys the diseased
portion of your varicose vein. The vein closes
and your body eventually absorbs it.
- ablation
Ablation involves the insertion of a thin, flexible
tube called a catheter inserted into a varicose
vein. The tip of the catheter heats the walls
of the varicose vein and destroys the vein tissue.
Once destroyed, the vein is no longer able to
carry blood and is absorbed by your body.
Surgical
approaches to the treatment of varicose veins
include:
- vein stripping
This procedure involves tying off all varicose
veins associated with the leg's main superficial
vein and removing it from the leg. The removal
of veins from the leg will not affect the blood
circulation in the leg as deeper veins will
be able to take care of the increased blood
circulation.
- small incision avulsion
This procedure involves passing hooks through
small incisions, and may be done alone or together
with vein stripping.
- transilluminated powered
phlebectomy
This vein removal procedure makes use of a bright
light to illuminate the vein. A device is passed
through a tiny incision and removes the vein
with suction.
Steps
to prevent varicose veins include maintaining
a healthy weight, exercising regularly, and elevating
the feet while sitting. Avoid clothing that constricts
your waist, groin, or legs, shoes with high heels,
and crossing the legs while sitting. Include high-fiber
foods in your diet since constipation may also
cause varicose veins. While these measures may
help prevent varicose veins in some people, they
may only slow the onset of the condition in individuals
who are susceptible.
Click
here to view the Online
Resources of Cardiovascular Disease
|
