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Varicose Veins

Background Knowledge ๐Ÿง 

Definition

Dilated, tortuous, and elongated superficial veins, typically seen in the legs.

Aetiology & Pathophysiology

  • Valvular incompetence in superficial veins.

  • Increased venous pressure leading to vein dilation and valve failure.

  • Primary varicose veins: Due to congenital weakness of vein wall.

  • Secondary varicose veins: Due to a known cause like deep vein thrombosis.

Risk Factors

  • Family history.

  • Ageing.

  • Female gender (hormonal influences).

  • Pregnancy.

  • Obesity.

  • Prolonged standing.

  • Deep vein thrombosis history.

Clinical Features ๐ŸŒก๏ธ

Clinical Presentation

  • Visible dilated veins on legs.

  • Leg heaviness or ache.

  • Nocturnal cramps.

  • Itching over veins.

  • Swelling in legs and ankles.

  • Skin discolouration, especially near the ankles (haemosiderin staining).

  • Complications: Eczema, ulcers, bleeding, thrombophlebitis.

Investigations ๐Ÿงช

Investigations

  • Doppler ultrasound: To evaluate venous reflux and patency.

  • Venography (less commonly used).

Management ๐Ÿฅผ

Management

  • Conservative: Compression stockings, elevation of legs, lifestyle modifications (e.g., weight loss, avoid prolonged standing).

  • Interventional: Sclerotherapy, endovenous laser therapy, radiofrequency ablation.

  • Surgical: Ligation and stripping, phlebectomy.

Prevention

  • Regular exercise.

  • Maintaining a healthy weight.

  • Avoiding prolonged standing or sitting.

  • Use of compression stockings if at risk.

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Which one of the following is a risk factor for varicose veins?

Pelvic tumours can block venous return, causing venous hypertension.

Prolonged standing can lead to venous hypertension


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