Varicose veins of the lower extremities are a chronic systemic pathology that develops against the background of dysfunction of the valves that control blood flow.
This leads to the accumulation of excess fluid in the veins, which gradually stretch, lose elasticity and strength.Varicose veins are characterized by the formation of bulky nodes under the skin of the legs, but this is not the only symptom of the disease.Patients complain of pain and heaviness in the legs, burning and itching, dryness, skin irritation.In advanced cases, non-healing purulent ulcers are formed on the skin, which are very difficult to treat due to irreversible necrotic processes.In order for the treatment of varicose veins in the legs to be effective and to prevent relapses, it is first necessary to find out its causes.
Causes of varicose veins in the legs
The tendency to develop such a serious vascular disease is often inherited, and in most cases this pathology is inherited by women.Therefore, if there is a family history of varicose veins, girls and women will be at risk.
Other common causes of the disease:
- Poor nutrition.If the diet is dominated by fatty, heavy foods rich in animal fat, the risk of developing varicose veins of the lower extremities increases significantly.
- Heavy physical activity.Certain types of work, for example, cook, waiter, surgeon, office worker, hairdresser, create conditions for a gradual increase in blood pressure.With constant stress, blood vessels and valves are deformed;As a result of constant high pressure, the walls of the vessels become thin, fragile, and varicose veins expand.
- Wearing uncomfortable high heels.Such shoes reduce the amplitude of muscle contraction and compress blood vessels, which in turn contributes to the disruption of blood flow and the development of varicose veins.
- Sedentary lifestyle.In the absence of at least a minimal load on the muscles, blood begins to stagnate in the venous bed, as the walls of the vessels do not contract by themselves.Gradually, the veins are stretched, the function of the valves is disturbed, varicose thickening and nodules are formed.
- Excessive weight.The more a person is overweight, the greater the load on the lower extremities and, accordingly, on the blood vessels.In addition, obese people move very little and eat mostly poorly, doubling the chance of developing varicose veins in the legs.
- Pregnancy.As the fetus grows, the blood volume in the future mother's body increases, which creates additional stress on the vessels.In addition, the growing uterus and fetus compress the pelvic veins, which prevents normal venous flow.During pregnancy, the hormone progesterone is produced in excess, which relaxes the walls of blood vessels and contributes to the development of varicose veins.In most cases, varicose veins are reversible during pregnancy, so after giving birth, a woman can completely get rid of the problem.
- Age.As the body ages, the walls of the vessels, as well as the valves, stop performing their functions and weaken.Elasticity and strength are lost, which causes veins to stretch.
The mechanism of development of varicose veins of the lower extremities
Varicose veins of the lower extremities develop according to a complex mechanism:
- In the initial stage, the presence of a hereditary tendency and exogenous and endogenous factors provoke a slowing down of venous blood flow.The process of long-term stagnation leads to the development of inflammatory processes in the walls and valves of the vessel.
- When the valves are incompetent and the walls of the venous vessels are weak, blood begins to flow through the veins in both directions.This leads to an increase in intra-venous pressure, which leads to excessive stretching and deformation of the vessel walls.
- Further stagnation of blood and the development of the inflammatory process contribute to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
The function of the affected vessels is gradually impaired.Varicose veins cause stagnation of blood in the veins, which leads to local toxic lesions, as well as increased pressure.In the advanced stages, the veins can no longer withstand the pressure, resulting in ruptures, which cause profuse bleeding.
Symptoms
The disease is insidious because it is practically asymptomatic in the early stages.The first symptom that indicates the development of varicose veins is fatigue in the legs, which is often ignored by patients and does not become a reason to consult a specialist.However, as the pathology progresses, fatigue in the legs is felt more often, especially in the evening, after a working day.Other symptoms of vascular disease:
- Pain, feeling of tightness.Such symptoms begin to appear from the second stage, when the pathological process begins to progress.The pain mainly occurs in the evening after a working day and disappears in the morning.If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and causes constant discomfort.
- Swollen veins and vascular network.At first, the affected veins are stronger than usual, but later they begin to bulge, swell, and form nodules.The vascular network is most often localized in the thighs and legs.
- Cramps.A characteristic symptom of varicose veins, the cause is stagnation of blood in the veins.Stagnant processes cause an increase in pressure in the vessels, as a result of which the muscles begin to contract on their own.
In addition, vascular diseases are clearly accompanied by external changes.With the development of ischemia, patients complain of constant itching.Excessive stretching and thinning of the veins leads to the formation of hematomas and bruises.In advanced stages, when atrophic processes develop, the following external symptoms appear:
- red spots on the skin;
- stripping;
- the formation of dark pigmented spots;
- loss of hair.
If the patient develops trophic ulcers accompanied by darkening of the extremities, this indicates the development of irreversible necrotic processes.
Complications of varicose veins of the legs
If varicose veins of the lower extremities are not treated, serious complications develop as the disease progresses, such as:
- Venous thrombosis.Pathological processes with this complication affect the deep veins.It is accompanied by blockage of a vessel with a pathological blood clot - thrombus.The main cause of venous thrombosis is the slowing down of blood flow in the lower extremities.
- Pulmonary embolism.A condition in which a blood clot separated from the vessel wall enters the pulmonary artery along with the blood flow and blocks its lumen.If the blood clot is large, death occurs immediately.Smaller clots are not fatal, but cause complex respiratory and circulatory disorders.
- Thrombophlebitis.It is characterized by inflammation of the superficial vessel walls accompanied by the formation of a blood clot.The disease is manifested by hyperemia, swelling along the inflamed and blocked vein, pain of varying intensity.Acute thrombophlebitis is accompanied by fever and chills, which complement the above symptoms.
- Trophic ulcers.An inevitable complication of untreated varicose veins of the lower extremities that develops in the absence of timely treatment.Disruption of tissue nutrition and the development of the inflammatory process contribute to the compression and thinning of the subcutaneous tissue, darkening of the skin, and then the formation of a non-healing trophic ulcer.
- Varicose eczema.It manifests itself as local redness of the skin, peeling, unbearable itching.In the absence of treatment, the complication spreads rapidly and causes the patient's condition to deteriorate.
- Bleeding from varicose veins.A dangerous complication that develops against the background of rupture of varicose veins.
Bleeding can occur due to mechanical damage, because the walls of the affected vessels are very fragile and thin.Therefore, even a small friction can cause severe venous bleeding.
Diagnosis of varicose veins of the lower extremities
If there are signs indicating the development of varicose veins of the lower extremities, you should make an appointment with a phlebologist who recognizes, treats and prevents this type of vascular pathology.
The doctor will be able to make a preliminary diagnosis during the initial examination, during which a dense vascular network, swollen veins protruding above the surface of the skin, and venous nodes in the limbs are detected.To confirm the diagnosis, a referral is made for further examination, including the following procedures:
- Doppler ultrasound;
- ultrasound duplex angioscanning;
- radionuclide and radiopaque phleboscintigraphy;
- phlebomanometry;
- plethysmography;
- photoplethysmography.
Treatment of varicose veins of the legs
If the disease is diagnosed in the earliest stages, if there are no serious complications, conservative therapy is prescribed, the main goals of which are:
- eliminate stagnant processes;
- normalize blood pressure;
- restore blood circulation;
- eliminate pathological symptoms.
For these purposes, drugs of the following groups are used:
- Venotonics and phlebotonics.It helps to improve the health of blood vessels, normalize blood circulation and improve lymph flow.
- Anticoagulants.It is used to reduce blood viscosity and prevent blood clotting.
- Nonsteroidal anti-inflammatory drugs.They have a clear anti-inflammatory effect and relieve pain.
- Antiplatelet agents.It reduces the risk of thrombosis and improves tissue trophism.
If drug treatment is ineffective and the disease progresses, the doctor discusses surgical treatment options with the patient.Surgical methods for treating varicose veins include:
- Sclerotherapy.Injection of a sclerosing drug into the lumen of the affected vessel, which glues the vessel, as a result of which it dissolves on its own, replaced by connective tissue.
- Laser coagulation.It is indicated in cases where the diameter of the affected vessels does not exceed 10 mm.Laser rays create a sclerosis effect in the vein, as a result of which it dissolves on its own.
- Phlebectomy.During the surgical intervention, the surgeon excises the deformed areas of the blood vessels by performing all the necessary manipulations through microscopic punctures in the skin.
Contraindications
For varicose veins in the legs, any actions that contribute to the development of stagnation in the veins of the lower extremities are contraindicated:
- staying in static positions for a long time;
- heavy physical activity, heavy lifting;
- sitting with legs bent or crossed;
- wearing tight, uncomfortable shoes.
It is also necessary to get rid of bad habits such as smoking and alcohol abuse.Tobacco smoke and alcohol have a negative effect on the health of the whole body, making the vessels fragile, thin and flexible, which soon leads to the development of varicose veins and other cardiovascular diseases.
The cost of treating varicose veins of the lower extremities
The cost of treating varicose veins in the legs is affected by the following factors:
- the stage at which the disease is diagnosed;
- associated complications;
- individually selected method of therapy - conservative or surgical;
- the need for additional therapeutic methods such as physiotherapy.