Dermatology - Varicose Veins
Varicose veins occur when there is a chronic problem with the flow of blood back to the heart, leading to increasing pressure in the capillaries. The highest occurrence of the beginning of symptoms often happens between the ages of 30 and 40, with women being afflicted three times more frequently than males. Varicose veins are a hereditary trait that is worsened by factors such as pregnancy, higher blood volume, increased cardiac output, elevated venocaval pressure, and the hormone progesterone. Legs may have a sensation of heaviness or pain, which worsens when standing and improves when walking. Superficial leg veins exhibit enlargement, tortuosity, and valve incompetence. The most effective evaluation of these veins is performed with the patient in a standing position. The occurrence of "blow-out" can be observed at locations where there are incompetent communicating veins. Varicose veins can be related to starburst phlebectasia, which typically occurs above an inadequate connecting vein. Superficial venectasias, also known as spider phlebectasia, may be present without a starburst pattern, but they are usually not indicative of chronic venous insufficiency. The diagnosis is established using the tourniquet test, wherein a tourniquet is given to the elevated leg to drain the veins. When the patient gets up and the tourniquet is removed, a varicose vein instantly fills up due to the absence or malfunctioning of valves. Doppler and color-coded duplex ultrasound can identify veins that are not functioning properly and discover blockages caused by blood clots. The effectiveness of injection sclerotherapy, which involves the injection of a sclerosing agent into varicosities and subsequent application of prolonged compression, has been established. Additionally, vascular surgery may be conducted.
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