Varicose Veins - Symptoms, Symptoms And Complications Of Varicose Veins

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms and complications of varicose veins

What is varicose veins?

Content:

• Causes of varicose veins
• Symptoms of varicose veins

• Complications of varicose veins

  • Venous insufficiency
  • Thrombophlebitis
  • Trophic ulcer
  • Thromboembolism
• Risk factors
• Treatment methods
• Prevention of varicose veins

Varicose veins are swelling of the peripheral veins under the skin, most often on the surface of the muscles of the legs, the veins take on the appearance of swollen and highly sinuous, bluish color. At the same time, nodes are formed, and the valve apparatus is destroyed. The outflow of blood in the veins cannot go in a standard way. When the valve flaps close, problems begin. Blood cannot move as it should - rising up. The veins are under pressure due to blood stasis.

When it becomes high - because of it, the blood is pushed out, and its excess stretches the walls of the veins, which are initially different in thickness. The vessels are stretched. Their edges are pressed against the skin and become visible. Because of this, characteristic "cobwebs" (vascular networks) are formed. If the vessel is visible through the layer of the epidermis, it means that it is weakened. The thicker the veins, the more noticeable their blue color. Nodules are created that are clearly visible on the legs.

This disease has been well known since antiquity. Archaeologists met the first references to this topic in the texts of the laws on medicine that were created in the Byzantine state. In the hands of the Egyptian pharaohs were elastic bandages, which help in the prevention of disease. Specialists in medicine, Hippocrates, Paracelsus, and also Avicenna, tried to discover methods of treatment.

This pathology is very common. Every fourth inhabitant of the planet suffers from it. Among the main factors of development is insufficient development of connective tissue. For the development of varicose veins, predisposing conditions are necessary. This partly explains why there are so many women among the phlebologist's visitors. In their body, the restructuring of hormones is especially active.

It is very important to take care of the condition of the veins on time. They cause a lot of anxiety, starting with the ugly legs. This is a big threat to health and even life. When this disease reaches a neglected state, its complications begin. Meanwhile, if you go to the doctors on time, it is not difficult to get rid of the disease. If you start treatment on time, surgery will not be required. This is the best way to get the veins to disappear by themselves and return to normal.

According to statistics, 18–20 percent of the population suffer from varicose veins, and almost 50% of patients in the initial stage do not even suspect that they are seriously ill. Most often, women suffer from this disease.

Causes of varicose veins

The causes of varicose veins can be prolonged standing, obesity, pregnancy, long wearing of stockings or socks with tight elastic bands, as well as congenital weakness of the connective tissue. The above refers to the primary causes of the development of the disease.

Varicose veins are formed when the blood runs incorrectly through the veins. Scientists have investigated the causes of this disease, not inherent in other living species to the extent that humans suffer from it. Among the established reasons:

• Walking upright. Researchers attribute the disease to the lower extremities by the excessive pressure exerted on them by the body. The column of blood continues up to the heart muscle. Those who spend a lot of time on their feet are at particular risk.
• Genetic predisposition. In most people, this disease turns out to be a factor transmitted from parents. The statistics in this case are very clear - in babies whose parents suffered from such a disease, the probability of getting varicose veins increases to 70%. But this risk can be avoided if no accompanying factors are created. Hereditary varicose veins often appear at a very early age.
• The nature of work, standard lifestyle. Many modern professions have a certain risk with lack of mobility. Phlebologists suggested using the term "computer varicose veins".

• Endocrine and hormonal disorders. Due to the characteristics of the body in women, periods of hormonal disruptions become the causes of blood stagnation. For them, the most dangerous periods are puberty, pregnancy, time after childbirth. The time when menopause comes is also dangerous. This gender category of patients visits doctors 2-3 times more often. There are not enough hormones in women's organs called estrogens. Instead, the so-called corpus luteum hormone predominates. It is believed that it is he who has a relaxing effect on the muscles. This promotes varicose veins.
• Obstacles in the outflow of blood through the veins. They arise as a purely mechanical formation - a blood clot, uterus, tumor.
• Stress and nervous disorders affect the state of blood vessels. There are nerve endings in the wall of the veins that give them elasticity. With an increase in pressure in them, exposure to toxins, alcohol, the lumen of the vessels loses its tone and expands.
• Arterial fistulas. May form due to pressure in the area of overflow of arterial blood cells.
• The so-called muscle pump is located in the calf muscles, and they constantly need to be activated. It is very important to monitor your health, avoiding lingering illnesses - coughs and seizures.

The factors contributing to the development of varicose veins can be overcome by monitoring your health.

Symptoms of varicose veins

In order not to miss the moment of the onset of the disease, you need to know the first symptoms of varicose veins and have time to take the necessary measures.

The main symptoms of varicose veins are:

• The appearance of pain in the legs, a feeling of warmth, and sometimes burning in the veins of the legs;
• Heaviness in the legs;
• In the evening, swelling appears on the legs;
• Leg cramps begin at night;
• Dilated veins;
• The skin of the lower leg becomes dark, seals appear, trophic ulcers are possible.

You can also identify the following symptoms of varicose veins:

• There are manifestations that cover only the popliteal fossa region, as well as the back surface of the legs. With thick skin, as well as with excessive hairiness of the legs, it appears less.
• Easily palpable - the affected veins appear twisted on palpation.
• If the patient is laid down by lifting his legs, the mesh disappears, and in the upright position it thickens again.
• There is a peculiar heaviness in the legs, dull pain, convulsions. The patient often complains of a burning sensation. The manifestations are especially aggravated in the evening, or after a period of prolonged standing.
• The feet can also swell, particularly in the soft tissue area. They are also found at the ankles, in the lower areas of the shins.

These are the main symptoms of varicose veins. They are aggravated if the disease is not treated in time. Trophic changes spread further, to the skin of the legs and feet. The epidermis becomes dry, blue in color, swelling easily occurs. Due to the progression of varicose veins, the following are observed:

• Pigmentation.
• Induction (seals).
• Trophic ulcers.
• Impaired skin nutrition.

If third-party symptoms of varicose veins appear, such as fever or weakness, it means that the disease has passed the stage of complications. There are such rare symptoms as bleeding when the nodes rupture. Most often they occur at night.

Complications of varicose veins

Complications of varicose veins take painful forms. They are easy to recognize by their manifestations:

• Acute stage of superficial vein thrombophlebitis.
• Trophic ulcer.
• Phlebothrombosis.
• Bleeding varicose veins.

Acute thrombophlebitis has the following differences:

• redness
• soreness
• noticeable seals according to the location of the subcutaneous vessels.

The resulting blood clots can enter a favorable course of the process, and then, against the background of the treatment being carried out, they are organized (germinate with connective tissue), and then dissolve. Thanks to this, the process of vessel recanalization begins. The gap may also be blocked completely. Because of this, there is a risk of obliteration and hardening of the affected vein.

With the progression of the disease, there are factors accompanying ascending varicothrombophlebitis. Following him comes lebothrombosis. It covers the deep vein system, pulmonary embolism begins. If you do not want to be treated, occlusion of the vessels of the limb is possible, when the outflow of blood stops, and gangrene begins.

Chronic venous insufficiency

Development goes through several stages. Initially, minimal changes in hemodynamics are considered, due to which horizontally directed veno-venous reflux is formed. At the same time, the valves of the communicating vessels begin to suffer from insufficiency, and the disease captures the areas of the saphenous veins, spreading to the deepest of them.

There are four stages that are characteristic of chronic venous insufficiency:

• Zero, no clear clinical symptoms. Edema is very little expressed, as is the visible ectasia of superficial veins.
• The first, characterized by a noticeable varicose veins of the lower extremities. There are no trophic disorders.
• The second, with obvious growth of veins. Characteristic nodes, a noticeably stable edematous syndrome, areas of hyperpigmentation, eczema lesions, trophic ulcers are formed. If an echographic study is carried out, then it is possible to reveal valve insufficiency of vessels of different types of collectors - superficial and deep.
• The third, in which the above symptoms are supplemented by a persistent type of trophic disorders, which are not covered by conservative treatment.

Chronic venous insufficiency has its own symptoms:

• itching
• pain,
• night-time cramps in the limbs,
• swelling
• stagnant formations in soft tissues,
• possibly ulcers.

This pathology is characterized by a certain pain syndrome - it intensifies when the patient places the lower limbs in a forced-type position, due to the use of elastic compression, walking with a walking step. There is a type of edema that proves that the deep veins are affected.

If only the superficial vessels are affected, it is possible to diagnose transient ankle pastiness, based on orthostasis (vertical position). The lower extremities are in a state of discomfort, which is why chronic venous insufficiency does not make it possible to conduct normal life activities. Physical activity decreases markedly, patients experience tension, emotional disruptions, inappropriate feelings of anxiety.

Decreased performance also leads to certain consequences. Because of them, self-esteem and social activity suffer. Disadaptation occurs in society. It is important to turn to medicine on time, in particular - to a phlebologist.

Thrombophlebitis of superficial veins

The essence of the pathology is in the formed blood clots that block the lumen in the subcutaneous vessels. At the same time, inflammation of the venous wall of the aseptic type develops. The viscosity of the blood increases, the venous outflow becomes difficult.

The site of localization of the disease is often the lower third of the thigh, possibly the upper third of the lower leg. In theory, every part of the body is affected by this disease. The large saphenous vein along with its tributaries (95%) is especially affected by the disease. Small - accounts for only 5% of cases.

Experts easily establish the disease, since the clinical manifestations of superficial vein thrombophlebitis are quite striking. The classic symptoms are as follows:

• hyperemia (redness) over the varicose vein,
• severe soreness
• general state of health does not change significantly (subfebrile condition, weakness),
• if you feel the affected vessel, you can determine the compaction of soft tissues,
• local hyperthermia.

With the development of pathology, it covers more and more veins. 10% of such cases lead to damage to the nearest vessels. Pulmonary embolism may develop.

Diagnosis of thrombophlebitis of this type is carried out in several stages:

• The exact location of the apex of the new thrombus is determined.
• The length and characteristics of pathological changes are revealed.
• Determination of the risk of developing life-threatening complications using ultrasound scanning of blood vessels based on color blood flow mapping.
• Determination of thrombosis by visualization of the inferior vena cava and iliac vessels of echographic examination.
• Untrained patients undergo radiopaque phlebography.
• A blood test, which in standard cases indicates moderate leukocytosis, an increase in the erythrocyte sedimentation rate, an increase in the concentration of fibrinogen and a C-reactive protein species.
• The coagulogram shifts to hypercoagulation.

For the treatment of thrombophlebitis of superficial veins, delay is unacceptable. At the first characteristic signs, they immediately turn to specialists. This is a vascular pathology in an acute form, it requires hospitalization in a hospital with emergency surgery.

Outpatient treatment is allowed if the pathology has not reached the limits of the lower leg. With conservative treatment, they resort to help:

• non-steroidal anti-inflammatory drugs,
• anticoagulants,
• angioprotectors,
• disaggregant.

It is necessary to determine the optimal motor regime, calculate the compression therapy formula. The operation is required only in certain cases - for example, with an ascending type of thrombophlebitis of the base trunk of the saphenous vein, when the apex is located above the middle third of the thigh.

Trophic ulcer

It appears as a result of a neglected form of the disease, with decompensation of venous outflow. Has certain symptoms:

• The formation of a trophic ulcer is slow.
• The permeability of the vascular wall increases, it enters the area of the bloodstream, where the erythrocytes contain degraded hemoglobin, with hemosiderin, due to which the dermis acquires an unnaturally dark color, hyperpigmentation appears.
• The process progresses to the formation of a whitish, lacquered seal, which is a pre-ulcer condition.

Because of any, the slightest injury, there is a danger of developing an ulcer.

With timely treatment, the deformity quickly closes. If there is no possibility of treatment, the ulcer progressively increases, perifocal inflammation develops in the soft tissue area. There is a risk of secondary infection, with the threat of purulent-septic complications of varying severity.

The treatment of trophic ulcers is preceded by its diagnosis, which is characterized by the absence of any difficulties. The disease is eliminated in several stages. First, scarring of the defect is necessary, and then the operation is performed.

Therapy is aimed at the peculiarity of the phase of the ulcerative process. During exudation, the wound substance is abundantly separated. This indicates an inflammatory reaction of the surrounding soft tissues, concomitant bacterial contamination. The patient must adhere to semi-bed rest for 14 days. There is also a course of broad-spectrum antibacterial drugs, non-steroidal anti-inflammatory drugs.

Infusion therapy, supplemented by antimycotics and nitroimidazole derivatives, can be prescribed. Local treatment is inevitable, with the obligatory daily two - three times toilet of the ulcerated area using an antiseptic solution, and then a bandage is applied on a water-soluble osmotically active ointment, a specially sorbing compress, an elastic bandage.

It is necessary to deal with the cleaning of the wound surface. If granulation tissue forms, the severity of perifocal inflammation decreases, then this is a signal for the next phase of repair.

A course of activities is assigned, whose task is to activate growth with the maturation of connective tissue elements. This will be helped by procedures of polyvalent venotonics, antioxidants, deproteinized derivatives of blood cells of calves of the Solcoseryl and Actovegin series, zinc hyaluronate. It is also necessary to undergo laser and ultraviolet blood irradiation. This will improve its rheology. Apply an elastic compress.

During epithelialization, it is necessary to protect the maturing scar. It should not be exposed to external mechanical damage. This is helped by medical compression hosiery or an elastic bandage procedure for sick lower extremities. The course of phlebotonics continues. When the defect is completely closed with new tissue, in the absence of contraindications, the stage of combined surgery begins.

Pulmonary embolism

It is an acute blockage of the pulmonary trunk, as well as the branches of the arterial system, which is represented by the pulmonary circulation by a thrombus. It is created in the large venous circulation, as well as in the right heart. The essence of thromboembolism is blockage of the arterial bed by a thrombus. In the standard version, a thrombus migrates into the pulmonary artery with its branches from the system of deep veins affected by disease in certain pathologies.

A disease such as pulmonary embolism is a common cause of sudden death.

You can list the risk factors due to which the disease appears:

• Oncological types of diseases.
• Surgical interventions performed.
• Heart failure attacks.
• Thrombophilia.
• Unnecessarily long bed rest.

These conditions often cause thrombosis of the veins of the lower extremities (legs). The consequence may be thromboembolism. Especially often female patients are exposed to illness. In this category, the normal process of blood circulation is more disturbed, as well as homeostasis. This disease also occurs in children. Often - as a result of complications of umbilical sepsis, or as a consequence of cauterization of the subclavian and umbilical veins. The symptoms of pulmonary embolism disease are as follows:

• Chest pain.
• Temperature increase.
• Collapse attacks.
• Tachycardia.
• Hemoptysis.
• Cyanosis.
• Cough.
• Moist wheezing.
• Dyspnea.

There are manifestations that depend on the individual symptoms. Then we can say about the following syndromes:

• Cardiac syndrome (at the same time there are chest pains, tachycardia, fainting, swelling of the cervical veins, increased cardiac impulse, the venous pulse becomes positive, especially against the background of massive pulmonary embolism).
• Pulmonary pleural (along with chest pain, shortness of breath, cough with sputum, exacerbated by a small submassive embolism, blockage of the peripherally branched artery of the pulmonary region may be observed).
• Cerebral syndrome, typical for the elderly (loss of consciousness, attacks of hypoxia, seizures, hemiplegia are characteristic).

It is very difficult to independently diagnose this disease. And the treatment itself should be carried out only by an experienced specialist. It is being built in an integrated manner.

The basis for it is the degree of severity, the duration of the disease. Conservative therapy can be used, which is combined with surgical treatment. Conservative therapy is based on the intake of anticoagulants, thrombolytics and antiplatelet agents, which help to restore permeability in the vessel, normalize hemostasis, and stop the destruction of thrombus cells. In the end, the identified manifestations of complications are treated.

Pulmonary embolectomy is operatively used. The procedure is carried out by specialists from specialized cardiovascular centers. If systemic hypotension is detected, high pressure of the right ventricle of the heart - surgery is required immediately. This interference is very serious. It is best to prevent this type of complication of venous insufficiency.

Risk factors for developing varicose veins

Now let's talk about the risk factors for varicose veins. Varicose veins can occur due to:

• hereditary predisposition;
• hormonal effects, in particular pregnancy;
• weight gain, obesity;
• lifestyle, work associated with heavy physical activity, prolonged standing on their feet or high ambient temperatures.

Watch your feet carefully! Most people, noticing the rapid fatigue of the legs, heaviness in the legs, associate this with anything, but not with the onset of a serious disease - varicose veins. And if you nevertheless tie together all the seemingly minor troubles of the legs, such as swelling in the legs, rapid fatigue of the legs, burning and warmth in the veins, bluish translucent wreaths, which are hardly noticeable at first, then here are the first signs of varicose veins. It is necessary to carry out prophylaxis for the treatment of varicose veins in order to avoid big problems with this ailment in the future.

Take care of your feet - and they will love you!

Treatment methods

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Prevention of varicose veins

Prevention of varicose veins is a system of methods. As a result, the emergence and

development of the disease can be prevented. It is built on:

• Optimal construction of modes in work and rest, which allows the best to reduce orthostatic loads, which is especially important in case of congenital predisposition.
• Selection of different body positions if you have to sit a lot.
• Abandoning the leg-to-leg position.
• Refusal of all things, due to which the lower limbs, groin area, waist are strongly squeezed, from stockings with tight elastic bands.
• Long walks in comfortable shoes, not tight, without heels and stiletto heels, which are allowed only on holidays, provided they are worn for the shortest duration.
• Avoiding constipation, which chronically increases the level of blood pressure in the small pelvis.

The following is allowed:

• Cycling (improves the work of the cardiovascular system).
• Swimming.
• Location during the rest of the legs on a certain elevation (at the level of 15-20 cm above the heart).
• Constant morning or evening exercises.
• Hirudotherapy.
• Optimal weight normalization.
• Healthy food menu.
• Quitting bad habits, smoking.
• Contrast shower procedures.
• From 1.5 liters of water per day.
• A special set of exercises to promote effective blood flow.
• Prescribed medications or herbal remedies to increase the tone of the venous wall.

These are simple measures. They are recommended for use in most cases when no acute contraindications have been identified.

Prevention of varicose veins is very important, especially in modern society. With the initial signs of varicose veins, it is possible, thanks to the observance of fairly simple rules, to slow down the development of the disease, as well as to avoid its further progression. To prevent varicose veins, try to avoid hot baths, saunas, and do not stay in the sun for a long time. All of the above helps to reduce venous tone, which contributes to blood congestion in the legs.

Also, for the prevention of varicose veins, in no case do not wear tightening things, such as socks and stockings with tight elastic bands, since such clothes strongly compress the veins, which can not have a positive effect on the health of the legs in the future. Also, you should not wear high heels, the heel should not be higher than four cm. It is not recommended to engage in sports such as tennis, weightlifting, bodybuilding, as these sports increase venous pressure in the legs. You should not sit cross-legged, as when throwing one knee over the other, a certain obstacle is created for normal blood flow in the legs.

Helpful hints. If after a long day at work or just at the end of the day you feel heaviness in your legs, then during rest or sleep try to keep your legs higher than your body position, that is, as if in an elevated state.

If at work you have to sit a lot or, on the contrary, stand a lot, then try to change the position of your legs as often as possible, that is, if you are standing, then shift from foot to foot, walk in place, if you are sitting, do rotation with your feet. Also, doctors advise rinsing your feet with cold water after taking a shower.

With varicose veins, there are several sports that have a positive effect on the limbs: swimming, walking, skiing and cycling.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.