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DISEASES
 VARICOSE VEINS Other Diseases:

 Varicose veins are veinsthat have become enlarged and tortuous. The term commonly refers to the veinson the leg, although varicose veins can occur elsewhere. Veinshave leaflet valves to prevent blood from flowing backwards (retrograde). Legmuscles pump the veins to return blood to the heart, against the effects ofgravity. When veins become varicose, the leaflets of the valves no longer meetproperly, and the valves don't work. This allows blood to flow backwards andthey enlarge even more. Varicose veins are most common in the superficial veinsof the legs, which are subject to high pressure when standing. Besides cosmeticproblems, varicose veins are often painful, especially when standing orwalking. They often itch, and scratching them can cause ulcers. Serious complications are rare. Becausemost of the blood in the legs is returned by the deep veins, the superficialveins, which return only about 10 per cent of the total blood of the legs,can usually be removed or ablated without serious harm. Varicose veins aredistinguished from reticular veins (blue veins) and telangiectasias(spider veins), which also involve valvular insufficiency, by the size andlocation of the veins.

Symptoms

  • Aching, heavy legs (often worse at night and after exercise).
  • Appearance of spider veins (telangiectasia) in the affected leg.
  • Ankle swelling.
  • A brownish-blue shiny skin discoloration near the affected veins.
  • Redness, dryness, and itchiness of areas of skin - termed stasis dermatitis or venous eczema, because of waste products building up in the leg.
  • Cramps may develop especially when making a sudden move as standing up.
  • Minor injuries to the area may bleed more than normal and/or take a long time to heal.
  • In some people the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard.
  • Restless legs syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency.
  • Whitened, irregular scar-like patches can appear at the ankles. This is known as atrophie blanche

Complications

Most varicose veins are relatively benign, but severe varicosities can leadto major complications, due to the poor circulation through the affected limb.

  • Pain, heaviness, inability to walk or stand for long hours thus hindering work.
  • Skin conditions / Dermatitis which could predispose skin loss.
  • Skin ulcers especially near the ankle, usually referred to as venous ulcers.
  • Development of carcinoma or sarcoma in longstanding venous ulcers. There have been over 100 reported cases of malignant transformation and the rate is reported as 0.4% to 1%.
  • Severe bleeding from minor trauma, of particular concern in the elderly.
  • Blood clotting within affected veins. Termed superficial thrombophlebitis. These are frequently isolated to the superficial veins, but can extend into deep veins becoming a more serious problem.
  • Acute fat necrosis can occur, especially at the ankle of overweight patients with varicose veins. Females are more frequently affected than males.
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