CVI is generally an indication of blood stasis or venous reflux, most commonly valvular incompetence in the low-pressure superficial venous system. The inability of blood to return to the heart from the legs causes it to pool and clot. CVI generally occurs within the deep veins (Deep Vein Thrombosis), may also be related to varicose twisting, valve malformations or pelvic tumors.
Obesity, inactivity, pregnancy, smoking and extended periods of standing or sitting tend to be the activity factors of most importance. Women often present varicose veins; men DVT but this may be associated with delayed reporting. Type II Diabetes may also suggest different gender propensities. People over 50 predominately display indicators.
CVI results from damage caused to the veins, though clotting itself can precipitate vascular dilation. Varicose veins are often hereditary as may be valve defections which can result in venous reflux. Other venous pathologies are associated with transient ischemia, edema, infarcts and hypertension. DVT suggests delayed recognition.
Signs & Symptoms
Leg or ankles swelling (initial);
Achy, tight, tired, restless, heavy legs can accompany or predate swelling;
Varicose or similar skin indication;
Discoloration of skin, or flaky, itchy or leather-like texture of skin; and Sores that won't heal; or Conditions associated with blood flow or clotting problems.
Relation to Pathophysiology
Signs particularly associated with work, age or other disease conditions are considered the best predictors of CVI. Congenital vein weakening can be tied to certain conditions (sickle cell), exacerbating the likelihood of CVI onset. Progressive diabetic indicators can present compounding conditions. Treatment should be planned accordingly.
Patients typically experience the symptomology with pain originating in the groin region or mid-proximal thigh. Large vein involvement in the calf can present in proximal calf with vein dilation extending upwards. Diagnosis is generally confirmed via Duplex ultrasound or Magnetic Resonance Venography.…