Venous disease is a group of disorders such as varicose veins, deep vein thrombosis, and chronic venous insufficiency. All of these are caused by damage to the veins or the valves that keep from blood from flowing backward. Venous disease is quite common, and its effects can range from merely cosmetic to amputation or death. It is important to see a doctor immediately if you have any of the symptoms of venous disease.
What Causes Venous Disease?
The veins in your legs are responsible for returning the oxygen-depleted blood back to the heart to be re-oxygenated. They must fight against gravity to accomplish this. The blood is pushed upwards by a series of muscles around the veins, and one-way valves trap the blood and prevent it from flowing back into the legs.
If the vein walls become thin or weakened, or if the valves are damaged, the blood is no longer forced to flow up out of the legs. This results in the blood pooling in the veins, causing further stretching of the vein walls, and more damage to the valves. Veins may twist and swell and become visible externally as varicose veins, or can result in more serious problems such as blood clots in the veins (deep vein thrombosis) or constant swelling of the legs (chronic venous insufficiency).
Types of Venous Disease
There are three major types of venous diseases: varicose veins, deep vein thrombosis (DVT), and chronic venous insufficiency (CVI).
Varicose veins are twisted, raised, veins that are close to the surface of the skin and therefore are visible externally. They are generally found on the legs, due to the stress of standing and walking, but can also appear other places. Varicose veins are distinguished from “spider veins” only by size; varicose veins are larger than 3mm in diameter.
- Legs may feel heavy, tired, or achy particularly after standing
- Legs may feel restless, particularly at night (Restless Legs Syndrome)
- Skin over varicose veins may be painful or itchy
- Skin around ankles may be painful or itchy
- Swollen ankles or feet
- Visible veins, possibly twisted, raised, and engorged
- Skin over visible veins may be shiny, brownish or bluish
- Minor injuries to the area may bleed more than normal
Deep Vein Thrombosis (DVT)
When the pooling blood coagulates and forms clots, it is called deep vein thrombosis (DVT). This can be very dangerous, because the clots can travel to the lungs and cause a pulmonary embolism. 2.5 million people each year experience DVT, and 200,000 people are killed by pulmonary embolism. Deep vein thrombosis can also cause serious damage to the one-way valves, making the pooling worse and leading to a disorder called chronic venous insufficiency.A blood clot is properly called a thrombus, so deep vein thrombosis is a blood clot in the deep veins (the largest veins).
- Aching in the calf or thigh
- Pulling sensation in the leg
- Tenderness when your leg is touched or squeezed
- Discomfort when your foot is pulled upward (do not try this deliberately as it could dislodge the clot)
- Pain in your leg when you stand or move
- Pain in your legs that that gets worse and may become constant
- Swelling of the leg
- Redness of the leg
- Excessive warmth of the leg
- Superficial veins may become visible in the upper leg and lower abdomen
Chronic Venous Insufficiency (CVI) or Chronic Venous Disease (CVD)
Chronic venous insufficiency (CVI) or chronic venous disease (CVD) occurs when the veins in your legs cannot pump the blood out of your legs. It can be caused when a blood clot from DVT clogs a vein and causes such pressure that the valves are damaged beyond recovery.
- Tight-feeling calves
- Legs may feel heavy, tired, achy, or “full”
- Pain while walking
- Pain shortly after you stop walking
- Pain can be relieved by resting and elevating legs
- Swollen ankles or legs
- Varicose veins
- Leg rashes, redness, or sores
- Leathery leg skin
- Non-healing open sores (ulcers)
Risk Factors for Venous Disease
- Family history
- Prolonged standing
- Prior blood clots