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 causes the accumulation of an excessive volume of fluid in the vessels, which gradually stretch, losing elasticity and strength.Varicose veins are characterized by the formation of voluminous 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 and irritation of the skin.In advanced cases, non-healing purulent ulcers form on the skin, which are very difficult to heal due to the irreversible necrotic processes that progress in them.For the treatment of varicose veins in the legs to be effective and help prevent relapses, it is necessary to first know their 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 are cases of varicose veins in your family, girls and women will be at risk.
Other common causes of the disease:
- Poor nutrition.If fatty and heavy foods, rich in animal fats, predominate in the diet, the risk of developing varicose veins in the lower extremities increases significantly.
- Intense physical activity.Certain types of work, for example, cook, waiter, surgeon, office worker, hairdresser, create conditions for a gradual increase in pressure in the veins.With regular stress, blood vessels and valves become deformed;Due to constant high pressure, the walls of the veins become thinner, brittle, and varicose veins develop.
- Wearing uncomfortable high-heeled shoes.These shoes reduce the amplitude of muscle contraction and compress blood vessels, which in turn contributes to impaired 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, since the walls of the veins do not contract on their own.Gradually, the vessels stretch, the function of the valves is disturbed, and thickenings and varicose nodules form.
- Overweight.The more excess weight a person has, the greater the load on the lower extremities and, consequently, on the blood vessels.In addition, obese people move very little and mostly eat poorly, which doubles the chances of suffering from varicose veins in the legs.
- Pregnancy.As the fetus grows, the volume of blood in the expectant mother's body increases, creating additional stress on the veins.Additionally, the uterus and growing fetus compress the pelvic vessels, preventing normal venous flow.During pregnancy, the hormone progesterone is produced in excess, which relaxes the walls of blood vessels, favoring the development of varicose veins.In most cases, varicose veins during pregnancy are reversible, so after childbirth the woman can completely get rid of the problem.
- Age.As the body ages, the walls of the veins, as well as the valves, stop fully performing their functions and weaken.Elasticity and strength are lost, causing the vessels 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:
- At the initial stage, in the presence of a hereditary predisposition and provoking exogenous and endogenous factors, a slowdown in venous blood flow occurs.A prolonged stagnation process provokes the development of inflammatory processes in the walls and valves of the vein.
- 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 intravenous pressure, which in turn leads to excessive stretching and deformation of the vessel walls.
- Further stagnation of blood and the progression of the inflammatory process contribute to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
Gradually, the function of the affected veins is affected.Varicose veins cause stagnation of blood in the vessels, which causes local toxic lesions, as well as increased pressure.In advanced stages, the vessels can no longer withstand the excess pressure, causing ruptures that lead to profuse bleeding.
Symptoms
The disease is insidious because in the early stages it is practically asymptomatic.The first sign indicating 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 frequently, manifesting itself especially at night, after a day of work.Other symptoms of vascular disease:
- Pain, feeling of oppression.These signs begin to appear in the second stage, when the pathological process begins to progress.The pain appears mainly in the evening after a day of work and disappears in the morning.If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and constantly worries.
- Swollen veins and vascular network.At first, the affected veins are stronger than usual, but then they begin to protrude, bulge and form nodes.The vascular network is most often located in the thighs and legs.
- Electric shock.A characteristic sign of varicose veins, the cause of which 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 spontaneously.
In addition, vascular disease is accompanied by pronounced external changes.With the development of ischemia, patients complain of constant itching.Excessive stretching and thinning of the veins causes bruising and bruising.In advanced stages, when atrophic processes develop, the following external symptoms appear:
- red spots on the skin;
- peeling;
- formation of dark pigmented spots;
- disappearance of hair.
If a patient develops trophic ulcers accompanied by blackening of the extremities, this indicates the progression of irreversible necrotic processes.
Complications of varicose veins in the legs.
If there is no treatment for varicose veins of the lower extremities, as the disease progresses, serious complications develop, such as:
- Venous thrombosis.With this complication, pathological processes affect the deep veins.The pathology is accompanied by a blockage of a vessel with a blood clot - a thrombus.The main cause of venous thrombosis is slowing blood flow in the lower extremities.
- Pulmonary embolism.A condition in which a blood clot that breaks away from the wall of a vessel, along with the bloodstream, enters the pulmonary artery and blocks its lumen.If the blood clot is large, death occurs instantly.Smaller clots do not cause death, but cause complex respiratory and circulatory disorders.
- Thrombophlebitis.It is characterized by inflammation of the walls of the superficial vessel, accompanied by the formation of a blood clot.The disease is manifested by hyperemia, swelling along the inflamed and blocked vein, pain of varying degrees of intensity.Acute thrombophlebitis is accompanied by fever and chills, which complement the previous symptoms.
- Trophic ulcers.An inevitable complication of untreated varicose veins of the lower extremities, which develops in the absence of timely treatment.Violation of tissue nutrition and the progression of the inflammatory process contribute to the compaction of the subcutaneous tissue, thinning and darkening of the skin, followed by the formation of a non-healing trophic ulcer.
- Varicose eczema.It manifests itself as local redness of the skin, peeling and unbearable itching.If there is no treatment, the complication spreads quickly and leads to a deterioration in the patient's condition.
- Bleeding from varicose veins.A dangerous complication that develops against the background of rupture of varicose nodes.
Bleeding can occur due to mechanical injury, since the walls of the affected veins are very fragile and thinned.Therefore, even slight friction can cause heavy venous bleeding.
Diagnosis of varicose veins of the lower extremities.
If you have symptoms indicating the development of varicose veins in the lower extremities, it is necessary to make an appointment with a phlebologist who will diagnose, treat and prevent such 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 from the surface of the skin, and venous nodes on the extremities are discovered.To confirm the diagnosis, you are referred for additional examination, which includes the following procedures:
- Doppler ultrasound;
- duplex ultrasound angioscanning;
- radionuclide and radiopaque phleboscintigraphy;
- phlebomanometry;
- plethysmography;
- photoplethysmography.
Treatment of varicose veins of the legs.
If the disease is diagnosed in the early stages, when there are no serious complications, conservative therapy is prescribed, the main goals of which are:
- eliminate stagnant processes;
- normalize pressure in the veins;
- restore blood circulation;
- eliminate pathological symptoms.
For these purposes, drugs from the following groups are used:
- Venotonics and phlebotonics.It helps improve the health of blood vessels, normalize blood circulation and improve lymphatic flow.
- Anticoagulants.It is used to reduce blood viscosity and prevent blood clots.
- Non-steroidal anti-inflammatory drugs.They have a pronounced anti-inflammatory effect and relieve pain.
- Antiplatelet agents.Reduce the risk of thrombosis and improve tissue trophism.
If drug treatment is not effective and the disease progresses, the doctor discusses surgical treatment options with the patient.Surgical methods to treat varicose veins include:
- Sclerotherapy.Introduction of a sclerosing drug into the lumen of the affected vein, which glues the vessel, so it resolves on its own and is replaced by connective tissue.
- Laser coagulation.Indicated in cases where the diameter of the affected veins does not exceed 10 mm.The laser rays create a sclerosis effect in the vessel, so it resolves on its own.
- Phlebectomy.Surgical intervention during which the surgeon removes deformed areas of blood vessels, performing all the necessary manipulations using microscopic punctures in the skin.
Contraindications
For varicose veins in the legs, any actions that contribute to the development of stagnation in the vessels of the lower extremities are contraindicated:
- prolonged stay in static positions;
- intense physical activity, lifting heavy weights;
- 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 negatively affect the health of the entire body, making the veins fragile, thinned and inelastic, which soon leads to the development of varicose veins and other cardiovascular diseases.
Cost of treatment of varicose veins of the lower extremities.
The cost of treating varicose veins in the legs is influenced by the following factors:
- the stage at which the disease was diagnosed;
- associated complications;
- individually selected method of therapy: conservative or surgical;
- the need for additional therapeutic techniques, such as physiotherapy.