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Venous insufficiency

What is venous insufficiency?

Dysfunction of the veins, by which the veins in the legs are most often affected, is called venous weakness (in medical terminology, venous insufficiency).

Function of the veins

Once the arterial system has transported oxygenated blood and nutrients to the outermost parts of the body, the venous system transports the blood back to the heart. The veins in the legs in particular have to pump the blood upwards against gravity. This is done by the leg muscles that squeeze the veins together every time they contract (calf muscle pump). Like non-return valves, the venous valves prevent the blood from flowing back down into the legs and pooling there.

How venous insufficiency develops

If the venous valves no longer close tightly, the blood in the veins can flow back down and it becomes congested and pools in the lower parts of the legs. The vein walls capitulate against the higher pressure and the veins widen. The result of this is that the venous valves now close even less than they did before. Moreover, the distended veins eventually become visible as thin spider veins and the larger veins as convoluted, bluish varicose veins, many of which also protrude conspicuously under the skin. The blood that has pooled in the veins also leads to fluid leaking out into the surrounding tissues. Therefore, swollen legs and thick ankles are also a sign of venous insufficiency. If the disease continues to progress further, doctors call it chronic venous insufficiency (CVI).

Causes of venous insufficiency

The risk of developing venous insufficiency rises with increasing age, usually those over 50. Someone with a history of blood clots is also a higher risk. Women are far more often affected than men. The reasons for this are the different structure of female connective tissue and the female hormone estrogen. This is why venous insufficiency also develops more frequently during pregnancy, because the estrogen concentration is particularly high during this time.  Hereditary predisposition is also a cause of venous insufficiency. In this case, several members of the family may suffer from the disease. Obesity and activities that require long periods of standing or sitting can also favor the onset of venous insufficiency.

What happens if venous insufficiency is not treated

Without treatment, the pressure and swelling can burst the tiny blood vessels in your legs called capillaries. This could turn your skin reddish-brown, especially at the ankles. This can lead to swelling and ulcers. These ulcers are tough to heal. Venous insufficiency is the trigger for a whole series of symptoms and disorders with increasingly grave consequences:

At the first sign of venous insufficiency, such as painful, tired, heavy or swollen legs and spider veins and varicose veins, a specialist (phlebologist, angiologist, vascular surgeon, dermatologist) should examine your legs. With an ultrasound examination (Doppler ultrasonography), the doctor can judge the state of your venous system and can recognize disorders and blood clots that may have formed.

If the venous system proves to be weak and is not treated promptly, it may progress to varicose veins and thromboses that also affect the deep venous system as a condition call deep vein thrombosis. 
If blood clots become dislodged from the thrombosis, this could lead to a life-threatening pulmonary embolism. Venous leg ulcers (ulcus cruris) is another effect of chronic venous insufficiency.

Tips for everyday living to prevent venous insufficiency

  • Avoid sitting or standing for long periods
  • Go for regular walks
  • Take the stairs, not the lift
  • Activate the legs' muscle pump with sports such as swimming, cycling and power walking
  • Strengthen your veins with vein exercises
  • Alternating hot and cold showers strengthen the vascular system
  • Make sure you drink enough
  • Keep your weight down
  • Don't wear any shoes with high heels
  • Wear medical compression stockings as soon as you notice the first signs of early venous insufficiency

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