What Is Varicose Veins: Symptoms and Diagnosis
What Are The Signs And Symptoms Of Varicose Veins?
- Feeling of heavy legs;
- Pain and/or onset of cramps in the lower limbs;
- Appearance of very visible enlarged veins;
- Increase in temperature localized to the area where the varicose vein is present;
- Itching in the legs , especially in the lower area and near the ankle;
- Appearance of swelling in the ankles and/or feet .
The reported disturbances are often due to the complications of varicose veins: initial eczematous -type skin alterations (redness and itching) are observed which progressively worsen until reaching varicose ulcer (bleeding lesion) . In other cases the patient may develop superficial phlebitis or have bleeding from rupture of varicosities, which frightens him enormously but which, fortunately, are always easily controllable. Due to the impaired circulation, the tissues of the affected parts are particularly sensitive to injury, thus infections and wounds heal
slowly and tend to turn into chronic (non-healable) varicose ulcers.
Women in particular are conditioned by the aesthetic problem connected not only to the humps of the varicose veins which protrude conspicuously, but also to the mere presence of small varicosities (reticular varices) and telangiectasias ( capillaries ) which mark the skin in a conspicuous way .
Diagnosis
How Are Varicose Veins Studied And Diagnosed?
The diagnosis of varicose disease is generally made on the basis of the clinical examination alone: the patient is placed upright and the entire limb is examined, both anteriorly and posteriorly. Particular attention must be paid to the region of the internal malleolus, the initial site of the edema. The varicose vein is palpated throughout its extension; it has an elastic consistency different from that of the surrounding tissue, is easily compressible and offers minimal resistance .
Also widely used are two very simple maneuvers to carry out even at home, but extremely useful:
Trendelenburg Test
The patient is placed in supine position (lying on his stomach) and the limb is lifted, thus emptying the superficial venous circulation.
Then a string is placed at the root of the thigh (blocking the blood which thus cannot descend), he is placed in orthostatism (standing position) and finally the string is removed.
If the blood flows from top to bottom it means that there is an incontinence of the valves of the system of the perforating veins so that the blood flows from the deep circle to the superficial one. If, on the other hand, the varicose veins no longer fill up, we are certainly dealing with primitive varicose veins from incontinence in the venous anatomical area of junction between the saphenous and femoral veins, at the root of the thigh.
Perthes Test
The standing patient, with normal varicose vein turgor, is reapplied with a tourniquet to the root of the thigh and made to walk. Walking determines the squeezing of blood from the superficial to the deep system. If the varicose veins are emptied, we are certainly dealing with a free deep venous circulation, because the blood from the superficial circulation flows there without problems. So we are dealing with a primary varicose syndrome
If the varices do not empty, we are dealing with an obstructed deep venous circulation and a secondary varicose syndrome to other causes.
If there are doubts about the presence of valvular incontinence or the primitivity of the varicose veins, it is advisable to perform a echo color Doppler examination, which is an instrumental examination with which venous regurgitation can be studied reliably; it is thus possible to visualize the valvular incontinence of the superficial venous system, accentuated by maneuvers such as that of Valsalva ( increase of pressure inside the abdomen) or compressions, which are sometimes requested of the patient during the examination to highlight the defect.
