If you answered, “yes” to any of these questions, you might have vein disease.
Typically, the early symptoms of vein disease, or venous insufficiency, are vague. Furthermore, due to their gradual and prolonged development, which sometimes takes years, people with this disease become used to the symptoms often interpreting them as a sign of becoming older or writing them off to diabetes or smoking. The initial symptoms of the disease are variable.
The most often complaint, however, is related to difficulties walking and is called “venous claudication”. Subjectively, it is described as heaviness, tiredness, easy fatigue of lower extremities, difficulties walking, standing or even sitting still.
Coincidentally, varicosities or spider veins might or might not be seen depending on multiple factors, including thickness of the skin and its color, amount of fat tissue under the skin and so on. The same applies to the other visible changes, such as pigmentation and others.
As the disease progresses, other varicose veins symptoms join. Some patients suffer from progressive disabling pain with no visible symptoms of the disease for years prior to the correct diagnosis made. While the others after a short period of swelling, develop infections, and trophic lesions with all their consequences. Yet, some other patients with no subjective symptoms or complaints suddenly start bleeding from a large varicose vein not visible to the naked eye.
A less typical presentation of the disease is the so-called “restless leg syndrome”. During this condition, people feel very uncomfortable keeping their legs still. The most discomfort takes place early at night, often immediately after going to bed.
Muscle cramps in the legs and feet , particularly at night or during any other horizontal or reclined position, are the most typical vein disease symptoms are similar in their physiology to the above restless leg syndrome.
Due to the complexities of vein disease symptoms, there are many terms that are associated with the field. Here’s a list of common terms that you may encounter during your research:
Fibrosis – Soft tissue located in a basin drained by the incompetent vein can become increasingly hard, leading to a condition called “fibrosis”. This process is similar to chronic inflammation. As the disease progresses with no treatment, repeatedly damaged tissue behave in a way, similar to repeatedly traumatized skin: it becomes callous.
Pigmentation – One of the typical sign of superficial venous insufficiency is brownish-black discoloration of the ankles of the affected person, or pigmentation. Under high pressure of the blood flowing in the opposite direction through the incompetent valves of the affected veins, not only serum leaks into tissue causing swelling, but also red blood cells sometimes escape through overstretched walls of the affected veins. They quickly become entrapped and destroyed in the surrounding such vein tissues, releasing hemoglobin, degradation of which frees up the iron. Oxygenated molecules of iron give the skin this typical and characteristic for venous insufficiency brownish-black pigmentation.
Redness – Type of infection caused by venous insufficiency is called reperfusion cellulitis, meaning diffuse infection of soft tissue due to perfusion with “used” venous blood. The appropriate treatment for such infection should be directed to its cause, venous insufficiency.
Reticular Veins – During development of venous incompetence regardless of its cause, the primary branches of insufficient veins become stretched across and along and form varicose veins, or varicosities. The same process affecting the most remote veins, called “venules”, or “venous capillaries”, leads to formation of the spider veins, also called “telangiectasia”. All the intermediate venous branches, located between primary branches and the terminal ones, normally usually non-visible, form so-called “reticular veins”. They are seen through the skin and are usually of bluish-greenish color. They do not bulge like varicose veins do and do not form cluster like spider veins. The correct treatment of the reticular veins is the one of the condition responsible for their development: venous insufficiency, meaning identification and treatment of the abnormal superficial vein or its collaterals feeding the reticular veins of concern.
Spider Veins – Spider veins, officially called telangiectasia, are dilated capillaries, terminal venules and terminal arterioles. Their increase in diameter is usually due either or both congenital weakening of the vessel wall and acquired increase in pressure of the blood entering them. Venous telangiectasias of lower extremities are almost always caused by superficial venous insufficiency. Being usually asymptomatic lesions having only cosmetic importance, rarely such telangiectasias can rupture and cause serious external bleeding.
Swelling – Swelling, or edema, is caused by superficial venous insufficiency and is often being confused with cardiogenic or nephrogenic edema, caused by heart or kidney failure correspondingly. Subsequently, edema of venous insufficiency is commonly being treated inappropriately. One of common examples of such treatment is the one with diuretics, or water pills. When our body retains excessive amount of water, like in the case of heart or kidney failure, diuretics are appropriate. If, however, the edema is due to superficial venous insufficiency, problem affecting only lower extremities, the cause of it is not retention, but rather inappropriate distribution of water. That is why diuretics are usually ineffective and often are contraindicated for treatment of lower extremities edema due by superficial venous insufficiency.
Varicose Veins – Varicosities or varicose vein are, despite common believe, not a disease, but rather a symptom of a disease, called superficial venous insufficiency. Coincidentally, varicose veins are far not common symptom of the above disease, meaning that majority of individuals suffering from superficial venous insufficiency do not have visible bulging vein on their skin. Technically speaking, in majority of patients with superficial venous insufficiency these varicosities can be seen with the ultrasound, but only some of those people have visible enlarged and twisted vein depending on the thickness of the skin, amount of subcutaneous fat, stage of the disease, depth of these veins etc. The difference between normal prominent veins and varicosities is presence of tortuosity. When veins become wider under pressure, they also become longer and develop tortuosity without having enough space to remain straight.
Wounds – Non-healing or slowly-healing open wounds are one of many complications of venous disease. They often are called “trophic ulcers” and are the most common lesions of lower extremities. The majority of remaining ones belong to either ischemic or diabetic (also known as “neuropathic”). The mechanism of their formation is multi-factorial. The main part of it, however, is due to the swelling. During venous insufficiency, because of elevated pressure in the veins with reversed blood flow, liquid part of blood called “plasma” leaks through the walls of the veins into the surrounding them tissue, causing swelling, or edema. The microscopic lesions of the skin we all acquire during normal activity serve as a gate of this fluid to come out of the tissue using the pathway of lesser resistance. Often venous stasis lesions weep fluid endlessly. Such wet environment not only prevents normal cells to grow successfully to cover the lesion, but also damages cells on the edge of the wound. As a result, the wound from small scratch growths into a round non-healing defect of the skin called ulcer. The fact that the tissue receive already used blood in superficial venous insufficiency serve as an additional factor in ulcer formation. Sometime, the pressure in the tissue is so high, that fluid leaks even through uninjured skin, causing the entire surface of skin to weep. This condition is called “anasarca”. Non-healing for a long time ulcers become infected. It is called “secondary infection”. An ulcer that fails to heal for months or years is under high risk of malignant transformation (developing cancer).
Appearance – It is estimated that over 25 million Americans have varicose veins or disorders responsible for their development. While varicose veins are not considered a great health risk per se, they do indicate presence of a profound circulatory abnormality, which in turn is an actual disease and is, therefore, responsible for not only further progression, but also for development of serious consequences. So, what can happen when the veins that are supposed to pump used blood upwards, back to your heart, do not do it anymore? Varicose and spider veins, are not an annoyance, but an early sign of serious medical condition, affecting not only appearance, but also your entire circulatory system, your health, your ability to work productively and to enjoy fully your time of work, and sometimes even your life.
New York Vein Treatment Center focuses on treating vein disease symptoms and complications of venous disorders. We helped thousands of patients in the New York area. Contact us to schedule your consultation.
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