Varicose veins

varicose veins

Varicose veinsare twisted, irregularly shaped and overly stretched venous vessels that have lost their elasticity. They have increased in length and width and look like twisted blue ropes, translucent under the skin.

Veins become like this when venous valves are missing or for some reason they cannot perform their functions. If the valves are not functioning properly, blood flows back through the veins, accumulating in the lower limbs. As a result, the veins lose their natural shape and a chain of various complications begins.

What do varicose veins look like?

Thepattern of varicose veinsis highly variable for different patients. In some patients, varicose veins are usually invisible. In others, they swell under the skin with twisting cords and knots. But we must not forget that the severity of the disease rarely corresponds to the severity of external manifestations.

How common are varicose veins?

Varicose veinsis one of the most common diseases of the vascular system. According to some statistical estimates, about one third of the total population of Western countries suffers from varicose veins. The number of people who have varicose veins increases with age, and women develop varicose veins much more often than men. According to statistics, in the age group under 25, only 8% of women suffer from varicose veins, and in the older age group - 55 years and older - the signs of varicose veins are detected in 64% of women.

How can you recognize varicose veins in yourself?

The most common signs of varicose veins are:

  • spread your legs,
  • dull pains,
  • feeling of heaviness
  • tiredness.

These signs are especially pronounced after prolonged static load (sitting or standing without movement) or after lifting and carrying weights. Often these symptoms appear or worsen in the evening. However, it is usually impossible to pinpoint exactly where it hurts. If these unpleasant symptoms (fatigue, heaviness and pain) disappear after resting with the legs raised, they are most likely caused byvaricose veins.

However, some other painful conditions may show the same symptoms. For an accurate diagnosis of the causes of the described symptoms, it is necessary to undergo an examination by a vascular surgeon.

Leg cramps

With varicose veins, painful nocturnal cramps in the leg muscles (in other words, "the leg joins") can actually occur. Most often, cramps appear in the calf muscles and can sometimes be so painful that the patient wakes up. Also, nocturnal cramps usually occur after a hard day, when the patient had to stand or sit a lot.

Where do varicose veins usually appear?

Varicose veinsmost often occurs on the surface of the lower limbs (in the lower leg and thigh), just under the skin. More often than others, the great saphenous vein, which runs along the inner surface of the leg from the ankle to the groin, suffers. The tributaries of the great saphenous vein are the first to undergo varicose transformation and can manifest themselves in the form of various forms of"venous networks"and"spider veins"disease inarea of the ankle inside the nodes of the large varicose veins.

Are varicose veins inherited?

Varicose veinsis definitely hereditary. Scientists even believe that they have succeeded in isolating a separate gene responsible for the development of varicose veins. It is not clear whether this gene causes malformations of the venous valves or malformations of the venous walls themselves.

Undoubtedly, these studies will help develop a method of gene therapy, perhaps the most promising way to prevent and treat varicose veins. Unfortunately, this is still a rather distant future and gene therapy is not yet available for patients with varicose veins.

Varicose veins of the lower limbs during pregnancy

Pregnancy does not cause varicose veins, but it often turns out to be a trigger for the appearance of varicose veins in those women who are predisposed to it. For example, in people with congenital insufficiency or even the absence of venous valves. This fact has been established quite definitively, because many pregnant women do not have varicose veins on their legs. Sometimesvariceal enlargementappears only during the fourth or fifth pregnancy. And in some women, having appeared during pregnancy, they disappear immediately after the birth of the baby.

Pregnancy acts as a trigger forvaricose veinsdue to the fact that intra-abdominal pressure increases during pregnancy (the pressure exerted by the fetus on the abdominal organs). In addition, the content of sex hormones in the woman's blood - estrogen and progesterone - increases sharply. These hormones in high concentration contribute to the softening of the venous walls, the veins are stretched and the valves cannot close due to this.

In the absence of correct correction, a detailed picture of chronic venous insufficiency is obtained.

Other causes of varicose veins

Such a widespread prevalence of varicose veins in highly developed countries is certainly associated with the lifestyle of the population. For example, we spend a lot of time sitting on chairs. From kindergarten to high school graduation, a person sits at least 40 hours a week (counting about 5 hours in the afternoon in class, 3 hours in the evening - doing homework, watching TV, and so on - 5 days a week). Now we multiply this clock by 10 months a year, and so - up to 17 years. So - work in some institute, where you need to sit even more. When a person sits in a chair, the veins running down the back of the thighs are compressed and the calf muscles (whose rhythmic contractions help move venous blood to the heart) don't work.

Another important factor is nutrition. In Western countries, people prefer a diet low in coarse fiber. With such a diet, there is a high tendency to constipation. This also has an extremely negative effect on the condition of the venous valves and contributes to the transformation of varicose veins.

Varicose veins in the elderly

Why arevaricose veinsmore common in older people and especially women?

  1. In short, because their vascular system wears down with age and, sooner or later, fails. However, there are still many objective reasons why older women are more likely to suffer from varicose veins than younger men and women. First, because women generally live a little longer than men, there are correspondingly more older women than older men, and their veins have been functioning for a longer period of time.
  2. Men don't get pregnant. Although the varicose veins that appeared in a woman during pregnancy disappear soon after the baby was born, however, within a few months, these veins became abnormally enlarged. And with age, all the muscles in the human body, including the smooth muscles of the vascular walls, become less elastic as in youth. And the veins that have already dilated once, during pregnancy, in old age again become slightly larger than normal.
  3. Today, many women over the age of 30 resort to hormone replacement therapy, originally intended to relieve the unpleasant symptoms of menopause. There is no doubt that HRT helps women look younger and feel better, and generally endure the menopausal years more easily. Doctors' observations confirm that hormone replacement therapy reduces the frequency of angina attacks to some extent and prevents the decrease in bone strength due to osteoporosis.

However, hormone supplementation at the same time softens the venous walls in the same way as the increased levels of estrogen and progesterone during pregnancy. This side effect of hormone pills is all the more dangerous because the vein walls are already becoming weaker, due to the natural age-related changes in the muscle layer. Hence, more clinical studies are needed to finally clarify this issue.

Varicose Veins Varicose Veins

Etymology

Varicose veinsare divided into two main groups:

  1. The first group includes primary varicose veins caused by a hereditary predisposition to varicose veins.
  2. The second group includes varicose veins that appear after damage to the venous walls following trauma with the formation of blood clots in the veins or thrombosis.

When a clot or thrombus passes through a vein, the integrity of the venous valves is disrupted and secondary varicose veins are formed.

Clinical aspects

The degree of clinical severity of the disease:

  • varicose veins.
  • healed trophic ulcer.
  • open trophic ulcer.
  • edema of the limbs.
  • "spider veins" and "venous networks".
  • trophic changes on the skin.

Anatomical aspects

From the departments involved in the development of the picture of chronic venous insufficiency. (superficial veins, deep veins, perforating veins).

Physiopathological aspects

With the main pathological process leading to the appearance of varicose veins

  • occlusion (closure of the lumen with a thrombus)
  • reflux (reverse movement of the blood)
  • combination of reflux and occlusion.

"Vascular asterisks" - is this also a manifestation of varicose veins?

Spider veinsare clumps of thin, purple or red vessels that appear around the knees or ankles. Sometimes such vascular "cobwebs" can appear on the face, near the nose. These vessels cannot be called varicose veins, by definition. These are in fact slightly dilated venules (vessels that connect the capillaries to the actual veins), which are located near the surface of the skin.

Such dilated venules appear due to increased levels of female sex hormones in the blood and are often found in women taking oral contraceptives. But venules can also expand in the presence of varicose veins not externally manifested by larger veins.

03.03.2021