Disorders of the Veins and Arteries
Pathophysiology of Chronic Venous Insufficiency and Deep Venous Thrombosis
The pathophysiology of Chronic venous insufficiency (CVI) is either obstruction or reflux of venous blood flow. It can develop from the protracted valvular incompetence of the superficial veins, deep veins or the perforating veins that connect them. In all these cases the result is venous hypertension of the lower extremities. The bicuspid valve which is located in the superficial and deep veins assists in ensuring that blood is pumped towards the heart and it prevents blood from refluxing towards the feet when the patient is standing in an upright position (Eberhardt & Raffetto, 2014). Perforating veins valve function by preventing the reflux of blood from the deep veins into the superficial veins. In normal conditions, when a patient is standing erect, venous return is pulsatile and the valves will open and close about 20 times per minute. Superficial vein valve failure occurs after the primary points of high leakage develop between the superficial systems and the deep system. This high pressure results in secondary valve failure when the normal superficial veins become widely dilated that the thin flaps of the venous valves will no longer make contact in the lumen of the vessel. With time these incompetent superficial veins will become visibly dilated and tortuous, and at this point, they are recognized as varicose veins.
Deep vein thrombosis (DVT) mainly develops in the calf veins and it grows...
References
Eberhardt, R. T., & Raffetto, J. D. (2014). Chronic venous insufficiency. Circulation, 130(4), 333-346.
Line, B. R. (2001). Pathophysiology and diagnosis of deep venous thrombosis. Paper presented at the Seminars in nuclear medicine.
SPIRIDON, M., & CORDUNEANU, D. (2017). Chronic Venous Insufficiency: a Frequently Underdiagnosed and Undertreated Pathology. Mædica, 12(1), 59.
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