cardiovascular disorders
Chronic Venous Insufficiency and Post Thrombotic Syndrome
Diagnosis of Chronic Venous Insufficiency
Clinical evaluation Ultrasonography to exclude DVT Diagnosis is usually based on history and physical examination. A clinical scoring system that ranks 5 symptoms (pain, cramps, heaviness, pruritus, paresthesia) and 6 signs (edema, hyperpigmentation, induration, venous ectasia, blanching hyperemia, pain with calf compression) on a scale of 0 (absent or minimal) to 3 (severe) is increasingly recognized as a standard diagnostic tool of disease severity ( Diagnosis reference ). Scores of 5 to 14 on 2 visits separated by Lower-extremity duplex ultrasonography reliably excludes or confirms DVT. Absence of edema and a reduced ankle-brachial index suggest Peripheral Arterial Disease rather than chronic venous insufficiency and post-thrombotic syndrome. 1.Kahn SR. Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome.J Thromb Haemost2009;7(5):884-888. doi:10.1111/j.1538-7836.2009.03339.x 