Introduction to Varicose Veins
I am very sure that if I mention the word veins, you would say without any doubt that you know the different types of veins in the body ranging from the Superior Vena Cava in the heart which carries deoxygenated blood from the head, upper extremities, and upper chest to the heart, Inferior Vena Cava which carries deoxygenated blood from the lower extremities which include the legs, and pelvis to the heart, the Coronary Veins which is the vein of the heart that drain blood from the heart muscle, Portal Veins as the name implies it carry blood to the liver for filtration from the digestive organs, Azygos Vein which is responsible for carrying blood from the thorax and abdomen to the superior vena cava, the Renal Veins which carries blood from the kidneys to the inferior vena cava, Hepatic Veins which is responsible for carrying blood from the liver to the inferior vena cava, and the Cephalic Vein which carries blood from the arm to the axillary vein. While you might be wondering how many veins you have in your body, I am yet to finish the countings but the truth remains that I am not here to discuss all the veins, I am here to talk about a vein that isn't part of the veins I have listed above. So that tells you to what extent your body is built in a very complex but organized manner. Today I will be talking about the Varicose Veins, which are superficial veins found in the leg but before I continue, let me quickly mention a few veins that are similar to the Varicose vein in the leg. They are; The Reticular veins, which are small dilated veins beneath the surface of the skin about 1 to 3mm in diameter which usually occur as a sign of underlying venous insufficiency. Another vein similar to the Varicose vein is Telangiectasia. Telangiectasias also known as spider veins or thread veins are dilated blood vessels in the skin that are about 1mm in diameter and are found in legs and faces. That said, let's go back to Varicose veins.
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Varicose Veins Development
Varicose veins are distended (swollen), twisted, superficial veins within the range of 3mm found in the leg and feet. Veins allow for blood flow towards the heart but when it comes to the legs, it requires the assistance of muscles which contracts to help squeeze blood upwards back to the heart against gravitational forces and the valves do the job of preventing the blood from going back downwards to the feet but there is a problem when the valve becomes incompetent thereby not being able to prevent blood going back into the feet and then begins to pool in the veins at the feet. Quickly, there are three veins that work hand in hand, the deep veins, the superficial veins, and the perforating veins. The perforating vein takes blood from the superficial vein to the deep veins then they are taken upwards but this does not happen in a reverse direction. An incompetent perforating vein would lead to blood flowing from the deep vein to the superficial veins, causing an overload of the vein in a process that leads to the dilation of the superficial veins which then become varicose veins.
Risk Factors and Presentation of Varicose Veins
Varicose veins are common in the elderly and aged. I see a lot of older people who have these veins in their legs, and it is also common in people who have a family history of such. Varicose veins are common in females possibly because they often come to be treated, and it is common in pregnant females. People who are obese and people who have occupations that have to do with prolonged standing also are at a high risk of having Varicose veins. People suffering from deep vein thrombosis are also at risk of having varicose veins.
People with Varicose veins have engorged and dilated superficial veins in their legs which could be asymptomatic or symptomatic. In cases where it is symptomatic, the veins could be heavy as a result of the blood pool in the vein. A dragging sensation can also be felt in the leg where the veins are. Varicose veins can cause aching, itching, burning, and muscle cramps, and patients could have edema in the legs. In some cases, usually related to light skin people, patients could exhibit signs of chronic venous insufficiency in the region where there will be a change in the color of the skin.
Diagnosis and Test for Varicose Veins
Diagnosing varicose test in the hospital includes applying pressure to the saphenofemoral junction and tapping the distal part of the varicose vein to feel a thrill at the junction, which signifies an incompetent vein between the junction and the vein. The test is known as Tap test. Another test that is done is the cough test which is done by applying pressure to the saphenofemoral junction and requesting the patient to cough, allowing to find thrills at the saphenofemoral junction, and the thrill is used to identify a dilated vein in the junction. The Trendelenburg test is another test that involves lifting the affected leg so as to help drain the vein of the affected leg after which a tourniquet is applied distally to the incompetent valve in the patient's thigh. Using a Duplex ultrasound scan will let the clinician understand the extent of the varicose veins in the legs by identifying the speed and volume of blood flowing in the veins.
Treatment and management
Let's quickly solve that of pregnancy because I can imagine a lot of people saying how will pregnant women cope with such. In pregnant women, there is an improvement after delivery, so it is important to watch weight during pregnancy. Management of Varicose veins is weight loss in obese people, keeping legs elevated, and compression stockings. Patients could be treated using surgical procedures such as endothermal ablation, Sclerotherapy which involves injecting the vein with irritant foam for vein closure, also vein stripping can be done which involves ligating and pulling out of the Varicose veins.
Summary
Before I leave, while veins are known to take blood to the heart and away from organs, some veins do not perform that function because they are already inflamed or dilated and one of them is the Varicose vein. Varicose veins can also present with complications such as bleeding after trauma, thrombosis in the superficial vein, and deep vein, as well as skin changes. When you notice an inflamed vein in your legs, do not be fast to call it a Varicose vein, there are a lot of things to rule out, so it is advisable to visit the hospital for treatment.