Varicose veins

varicose veins

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

Veins become like this when the venous valves are missing or for some reason cannot perform their functions. If the valves do not work properly, blood flows backward through the veins, accumulating in the lower extremities. 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 generally invisible. In others, they bulge under the skin with wriggling ropes and knots. But we must not forget that the severity of the disease rarely corresponds to the severity of external manifestations.

How common is varicose veins?

Varicose veinsis one of the most common diseases of the vascular system. According to some statistical estimates, about a 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 years old, only 8% of women suffer from varicose veins, and in the older age group - from 55 years and older - 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:

  • spreading legs,
  • dull pains,
  • feeling of heaviness
  • tiredness.

These signs are especially pronounced after prolonged static load (sitting or standing without movement) or 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 raised legs, then they are indeed most likely caused byvaricose veins.

However, some other painful conditions can 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 muscles of the legs can indeed occur (in other words, "it brings the leg together"). Most often, cramps appear in the calf muscles and can sometimes be so painful that the patient wakes up. Moreover, night 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 extremities (in the lower leg and thigh area), just under the skin. More often than others, the large saphenous vein, which runs along the inner surface of the leg from the ankle to the groin, suffers. It is the tributaries of the great saphenous vein that are the first to undergo varicose transformation and can manifest themselves in the form of various forms of the disease from"venous networks"and"spider veins"in the area of the inner ankle to large varicose veinsnodes.

Is varicose veins inherited?

Varicose veinsis definitely hereditary. Scientists even believe that they managed to isolate a separate gene responsible for the development of varicose veins. It is not yet clear whether this gene causes malformations of the venous valves or malformations of the vein 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 matter of a rather distant future, and gene therapy is not yet available to patients with varicose veins.

Varicose veins of the lower extremities during pregnancy

Pregnancy does not cause varicose veins, but it often turns out to be a triggering factor 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 definitely, because many pregnant women do not have any varicose veins on their legs. Sometimesvaricose enlargementappears only during the fourth or fifth pregnancy. And in some women, they, having appeared during pregnancy, disappear immediately after the birth of the child.

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

In the absence of proper correction, a detailed picture of chronic venous insufficiency arises.

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 graduation from school, 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. Then - work in some institution, where you have to sit even more. When a person sits on a chair, the veins running along the back of the thighs are compressed, and the calf muscles (whose rhythmic contractions help move venous blood to the heart) do not 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 varicose transformation.

Varicose veins in the elderly

Why arevaricose veinsmore common in older people, and especially often in women?

  1. In short, because their vascular system wears out with age and, sooner or later, fails. Nevertheless, there are still many objective reasons why older women are more likely to suffer from varicose veins than young men and women. First, since women generally live a little longer than men, there are correspondingly more older women than older men, and their veins have worked for a longer period of time.
  2. Men don't get pregnant. Even if the varicose veins that appeared in a woman during pregnancy disappear soon after the birth of the child, all the same, within a few months, these veins were abnormally enlarged. And with age, all the muscles of the human body, including the smooth muscles of the vascular walls, become not as elastic as in youth. And the veins that have already dilated at some time during pregnancy, in old age, again become a little wider than normal.
  3. Nowadays, many women over the age of 30 resort to hormone replacement therapy, originally intended to relieve unpleasant symptoms of menopause. There is no doubt that hormone replacement therapy helps women both look younger and feel better, and generally endure the years of menopause more easily. Observations of doctors confirm that hormone replacement therapy to some extent reduces the frequency of angina attacks and prevents the decrease in bone strength due to osteoporosis.

However, hormonal 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 hormonal pills is all the more dangerous because the walls of the veins are already becoming weaker - due to natural age-related changes in the muscle layer. So, 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 as a result of 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.
  • limb edema.
  • "spider veins" and "venous meshes".
  • trophic changes on the skin.

Anatomical aspects

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

Pathophysiological aspects

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

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

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

Spider veinsare tufts of thin, purple or red thread 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. In fact, these are slightly dilated venules (vessels that connect capillaries to the veins proper), which are located close to 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 externally not manifested varicose veins of larger veins.

03.03.2021