Varicose Veins

Question 1

Define varicose veins

Answer 1

Subcutaneous permanently dilated veins >3mm due to valve incompetence

Question 2

What are the causes/risk factors of varicose veins?

Answer 2

• Family history
• Female
• Pregnancy - ↑ total body fluid
and intraabdominal pressure; ↑
oestrogen and progesterone ->
venous dilation
• Previous DVT
• Occupation (prolonged
standing)
• Obesity

Question 3

What are the symptoms of varicose veins?

Answer 3

• Dilated tortuous veins
• Leg fatigue/aching
• Leg cramps
• Restless legs
• Itching
• Ankle swelling
• Ulceration

Question 4

What are the signs of varicose veins?

Answer 4

• Venous eczema (haemosiderin deposition)
• Lipodermatosclerosis – progressive fibrosis of dermis and SC tissues -> indurated,
lichenified, reddish- brown skin changes
• Corona phlebetatica

Question 5

What investigations are carried out for varicose veins?

Answer 5

duplex ultrasound - assesses for reversed flow; roughly, valve closure time >0.5 second is indicative of reflux, while valve closure time >1.0 second is indicative of reflux in the deep system