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Varicose Veins

Varicose veins are veins on the leg which are large, twisted, and ropelike, and can cause pain, swelling, or itching. They are an extreme form of telangiectasia, or spider veins. They occur in 25-30% of the western population. Male and females are equally affected. 1 in 8 teenagers develop early signs of "leaking valves".
 
Varicose veins result due to insufficiency of the valves in the communicating veins. These are veins which link the superficial and deep veins of the lower limb. Normally, blood flows from the superficial to the deep veins, facilitating return of blood to the heart. However, when the valve becomes defective, blood is forced into the superficial veins by the action of the muscle pump (which normally aids return of blood to the heart by compressing the deep veins).
 

Symptoms:

  • Aching, heavy legs (often worse at night)
  • A brownish-blue shiny skin discoloration around the veins
  • Skin over the vein may become dry, itchy and thin, leading to eczema (venous eczema)
  • The skin may darken (stasis dermatitis), because of the waste products building up in the legs
  • Minor injuries to the area may bleed more than normal and/or take a long time to heal
  • Rerely, there is a large amount of bleeding from a ruptured vein
  • In some people, the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard.
  • Restless Leg Syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency.

Complications:

Most varicose veins are relatively benign, but severe varicosities can lead to 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
  • Ulcer : non healing varicose ulcer could threaten limb amputation
  • Coagulation of blood in varicose veins cause superficial thrombosis, deep vein thrombosis (DVT) & could precipitate stroke in the rare cause of predisposed individuals (that is, patients with patent foramen ovale). 
  • Cancer: long standing venous ulcer has the potential risk for cancer.

Causes:

Varicose veins are more common in women than in men, and are linked with heredity. Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury and abdominal straining. Varicose veins are bulging veins that are larger than spider veins, typically 3 mm or more in diameter
 
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