Understanding Chronic Venous Insufficiency
Problems with the veins in the legs may lead to chronic venous insufficiency (CVI). CVI means that there is a long-term problem with the veins not being able to pump blood back to your heart. When this happens, blood stays in the legs and causes swelling and aching.
Two problems that may lead to chronic venous insufficiency are:
Damaged valves. Valves keep blood flowing from the legs through the blood vessels and back to the heart. When the valves are damaged, blood does not flow as well.
Deep vein thrombosis (DVT). Blood clots may form in the deep veins of the legs. This may cause pain, redness, and swelling in the legs. It may also block the flow of blood back to the heart. Seek medical care right away if you have these symptoms.
A blood clot in the leg can also break off and travel to the lungs. This is called pulmonary embolism (PE). In the lungs, the clot can cut off the flow of blood. This may cause chest pain, trouble breathing, sweating, a fast heartbeat, coughing (may cough up blood), and fainting. It is a medical emergency and may cause death. Call 911 if you have these symptoms.
Healthcare providers call the two conditions, DVT and PE, venous thromboembolism (VTE).
CVI can’t be cured, but you can control leg swelling to reduce the likelihood of ulcers (sores).
Recognizing the symptoms
Be aware of the following:
If you stand or sit with your feet down for long periods, your legs may ache or feel heavy.
Swollen ankles are possibly the most common symptom of CVI.
As swelling increases, the skin over your ankles may show red spots or a brownish tinge. The skin may feel leathery or scaly, and may start to itch.
If swelling is not controlled, an ulcer (open wound) may form.
What you can do
Reduce your risk of developing ulcers by doing the following:
Increase blood flow back to your heart by elevating your legs, exercising daily, and wearing elastic stockings.
Boost blood flow in your legs by losing excess weight.
If you must stand or sit in one place for a period of time, keep your blood moving by wiggling your toes, shifting your body position, and rising up on the balls of your feet.
March 16, 2019
Medical Management of Lower Extremity Chronic Venous Disease. UpToDate
Deepak Sudheendra MD