Varicose Veins

Question 1

What are varicose veins and why do they form?

Answer 1

Distended torturous veins >3mm diameter

Incompetence in valves of perforating veins (which normally connect deep and superficial veins to allow blood to flow from sup to deep) leads to back flow of blood from deep veins to superficial veins= OVERLOAD causing dilation

Question 2

How might someone with varicose veins present? What are possible complications of VV?

Answer 2

Aches and pain in calf
Itching
Restless legs
Swelling

Bleeding
Eczema
Ulcers
Phlebitis

Question 3

What are the risk factors for VV?

Answer 3

Increased age 
Family HX
Female 
Pregnancy 
Obesity 
Prolonged standing 
DVT= damaged valves

Question 4

What are the Tap and cough test?

Answer 4

Tap test:

• pressure on SFJ and tap distal VV
• palpation of thrill in SFJ suggested incompetent valve between varicose vein and SFJ

Cough test:

• pressure to SFJ and ask patient to cough
• palpation of thrill indicates dilated vein at SFJ= SAPHENOUS VARIX

Question 5

How are VV managed?

Answer 5

Physical activity
Elevation of leg to help drainage
Compression socks (after atrial disease excluded) i.e. gradual compression stockings (GCS)

Endothermal ablation
Sclerotherapy = irritant foam injection into vein to cause closure
Stripping = ligation of vein