Varicose veins

Question 1

How common is it?

Answer 1

Prevalence data vary, but roughly 10-20% of men and 25-33% of women.

Question 2

Who does it affect?

Answer 2

Women more than men. Also pregnant ladies, 40% get them.

Question 3

What causes it?

Answer 3

Incompetent valves in the affected vein, which results in reflux of blood and increased pressure in the vein distally. The increase in venous pressure in the leg is usually particularly marked if there is also incompetence in deep veins. Varicose veins can appear and worsen in pregnancy because of: and increase in blood volume putting increased strain on the venous system, hormones causing relaxation of the muscle walls of blood vessels and the enlarging uterus putting pressure on the pelvic veins and IVC.

Question 4

What risk factors are there?

Answer 4

Age

sex

FHx

obesity

standing or sitting for long periods of time.

Question 5

How does it present?

Answer 5

Dark blue or purple veins, that appear twisted and bulging.

May also get an itch, discomfort, and swelling of the affected leg.

Question 6

Signs on examination?

Answer 6

Check for complications such as skin changes, venous leg ulcers and thrombophlebitis

Question 7

Treatment

Answer 7

Explain what varicose veins are and reassure that it is unlikely they will lead to complications. If a pregnant woman has varicose veins, she should be advised they are common and will usually improve considerably after pregnancy. Offering lifestyle advice, including avoidance of sitting or standing for long periods of time, and elevating the legs where possible. Consider the use of compression stockings. They can be removed, and can have them shut with intraluminal laser surgery, but the NHS probably only covers this in rare scenarios.