About Normal Vein Flow
Venous flow in the legs consists of superficial and deep components and their tributaries. When a person shifts from a horizontal to a vertical position, blood stored in the abdominal and pelvic veins is prevented from flowing down into the leg by rapid closure of functioning valves.
About Abnormal Flow in Venous Disease
Stress is placed on the valves by the force of gravity (hydrostatic pressure) and also from episodic pressure increases such as straining or coughing. As the vein stretches, the valve starts to leak or “reflux.”
Varicose veins are typically the result of degradation of the walls of the veins.
While varicose veins have a wide spectrum of appearance, they may have common patterns of distribution. Varicose veins may be large, firm, blue and tender. Others may be less readily palpable and may have a more greenish appearance. Telangiectsia, more commonly referred to as “spider veins” may be fine and range in color from red to blue and even grey.
What causes my varicose veins?
Varicose veins and other vein disorders are common within families. Epidemiologic studies show that patients have a higher likelihood of developing varicose veins if their parents had varicose veins, particularly from their fathers. Women are thought to develop varicosities as a consequence of the effect of their progesterone metabolism.
Obesity, certain heart conditions, lifestyles, and some occupations requiring prolonged standing will increase the pressure within the venous system.
Here are just a few self-treatment options for varicose veins:
Exercise regularly with attention to flexing your calves. Calf muscle flexion is a very effective pump for the venous system.
Whenever possible, sit with your legs elevated. This reduces the effect of gravity on the legs.
Wear support compression hosiery. Avoid tight garments touting “control” around the abdomen or waist.
Conservative self-care may help reduce the pain and prevent varicose veins from worsening, but it will not correct the flow disorder once it occurs. Dr. Lorenzo has in-office treatment options that can lessen the pain and diminish the appearance of the varicose veins by correcting the flow problem that causes them.
Symptoms of a more serious medical problem
If an area of one leg becomes red and tender, this can be a symptom of thrombophlebitis or inflammation of a superficial vein. If Dr. Lorenzo determines you have this condition, it may be treated with anti-inflammatories or other medications. A sample of blood may be taken to determine if underlying clotting abnormalities exist.
If your calf is painful and swollen, this may be indicative of deep vein thrombosis (DVT), a condition that occurs when a blood clot blocks a vein in the leg. Individuals who take birth control pills, hormone or steroid therapy or those who are immobilized are prone to developing thrombus. This is a very serious condition and warrants evaluation by a medical professional without delay.
Swelling occurs in patients with venous insufficiency, lymphatic disorders and many other inciting conditions. Not all swelling is necessarily dangerous.
During the course of the day, there may be some deterioration in valve function, even in normal extremities. The congestion is more exaggerated, however, in patients with reflux in that there is more leakage of the fluid component of the blood.
In severe cases, venous and circulatory congestion results in leakage of cells and proteins in the tissue.
Venous Stasis Ulcers
Protein deposition in the soft tissue is a stimulus for inflammation which recruits cells that further escalate the inflammatory process. The result is fibrosis of the skin and ulcer formation. The cycle of ulcer formation and healing followed by recurrent ulceration results in further thickening of the skin and areas of scarring, known as atrophie blanche.
Effects of Pregnancy
Even prior to the uterus enlarging significantly, hormonal factors cause the veins to become more compliant. Together with the increased pressure from the enlarging uterus and increased blood volume, significant venous distension and congestion are common late in pregnancy. This predisposes a patient to venous dysfunction that may persist post-partum.