Q&A: Chronic Venous Insufficiency
Unless they suffer from chronic venous insufficiency (CVI), chances are most people were not familiar with this condition before President Trump’s diagnosis was publicized last week.
What is CVI?
The veins in the legs transport blood to the heart. When the valves in these veins do not work properly, the blood does not flow towards the heart causing it to pool in the legs. The pooling increases pressure in the legs which can lead to bursting blood vessels.
What causes CVI?
While some people are born with malformations in their legs, the most common cause of CVI is deep vein thrombosis (DVT). DVT is a serious condition where a blood clot forms in a deep vein – often in the legs. Smoking, obesity, pregnancy and some medications can increase the risk of DVT.
Is CVI common?
Chronic venous insufficiency affects approximately 5% of the adult population or 1 in 20 people.
Who develops CVI?
This condition usually affects people age 50 and older with the risk increasing as people age.
What are the symptoms?
Symptoms may be mild during early onset, but as the condition progresses, it can lead to serious complications. Common symptoms in the leg may include:
- Ache
- Burning or tingling
- Itchy or flaking skin
- Night cramps
- Discolored skin
- Swelling in the lower legs and ankles while standing
- Ulcers
- Varicose veins
The number and severity of the symptoms depend on how the condition has progressed. Some people only have one or two of these symptoms.
“While typically non-life-threatening, if left untreated, CVI can lead to painful and debilitating complications,” said Forozan Navid, MD, a board-certified cardiovascular surgeon at Penn Highlands Healthcare. “Depending on the stage of the condition, the pain can be disabling and lower a person’s quality of life.”
How is CVI diagnosed?
To diagnose CVI, the provider will typically begin by reviewing a person’s medical history and performing a physical exam. Ultrasound will be used to examine the blood vessels in the legs to determine if the blood is flowing backwards. Magnetic resonance angiography or CT scans may be used to identify blockages and narrow veins.
What is the treatment?
The severity of the condition determines the best treatment plan. The ultimate goal is to prevent swelling and ulcers from forming. Providers often begin by recommending lifestyle changes such as leg elevation, exercise and compression stockings to improve the blood flow. Medications may be prescribed to reduce inflammation. Minimally invasive procedures may be performed to restrict the blood flow in damaged veins. In severe cases, surgical interventions may be necessary such as vein stripping.
“The mainstay of therapy is compression, said Dr. Navid. “There are now some portable non-pneumatic compression devices which may be appropriate for specific patients.”
Where can I get help?
People who suspect they may have CVI, should start by consulting their primary care provider. A family medicine physician or internal medicine provider is the best source for the initial diagnosis and referral to a vascular specialist.
Penn Highlands Healthcare offers primary care providers, including family medicine, internal medicine and women’s health providers, who can diagnose CVI while delivering compassionate and personalized care. The health system also has board-certified vascular surgeons who evaluate patients and provide cutting edge, minimally invasive surgery options for people suffering from CVI and various other vascular conditions. For a provider in your region, visit www.phhealthcare.org/findadoc.
