Chronic venous disease

Chronic Venous Disease (CVD) is a medical condition characterized by the improper functioning of the veins in the legs, leading to various symptoms and complications. It encompasses a spectrum of disorders that include varicose veins, chronic venous insufficiency, and, in its most severe form, venous ulcers. The progression of CVD is often described by the CEAP classification, which stands for Clinical, Etiological, Anatomical, and Pathophysiological criteria.

Causes and Risk Factors

Chronic Venous Disease is primarily caused by valvular incompetence, which leads to venous hypertension. This condition can be exacerbated by a history of Deep Vein Thrombosis (DVT), obesity, pregnancy, prolonged standing or sitting, age, and a family history of venous disorders. The failure of venous valves leads to the backflow of blood, increasing pressure in the veins, and resulting in the dilation, elongation, and tortuosity of the vessels.

Symptoms

Symptoms of CVD vary depending on the severity and include leg heaviness, swelling (edema), skin changes, varicose veins, and, in advanced cases, venous ulcers. Patients may also experience aching pain, cramps, itching, and a sensation of fatigue in the legs.

Diagnosis

Diagnosis of Chronic Venous Disease involves a physical examination and may be supplemented by duplex ultrasonography, which assesses the direction of blood flow in the veins and identifies any obstructions or valve malfunctions.

Treatment

Treatment options for CVD aim to alleviate symptoms, prevent complications, and improve quality of life. They include lifestyle modifications such as leg elevation, wearing compression stockings, exercise, and weight management. In more severe cases, interventions may include sclerotherapy, endovenous thermal ablation, and surgery to remove or repair damaged veins.

Prevention

Preventive measures for Chronic Venous Disease focus on mitigating risk factors. Regular exercise, maintaining a healthy weight, avoiding prolonged periods of standing or sitting, and wearing compression stockings can help reduce the risk of developing CVD.

Complications

If left untreated, Chronic Venous Disease can lead to serious complications, including venous leg ulcers, which are challenging to treat and significantly impair quality of life. Additionally, chronic venous insufficiency can lead to skin changes such as hyperpigmentation, eczema, and lipodermatosclerosis.