heart and blood vessel disorders
Chronic Venous Insufficiency and Post Thrombotic Syndrome
Symptoms of Chronic Venous Insufficiency
People with chronic venous insufficiency have leg swelling ( Swelling ), which typically is worse at the end of the day because blood must flow upward against gravity when a person is standing or sitting. Overnight, edema subsides because the veins empty well when people lie down. The swelling may not cause any symptoms, but some people feel fullness, heaviness, aching, cramps, pain, tiredness, and tingling in the legs. Varicose Veins may be present. Later on, the skin on the inside of the ankle becomes scaly and itchy and may become discolored. The discoloration is caused by red blood cells that escape from swollen (distended) veins into the skin. The discolored skin is vulnerable, and even a minor injury, such as that from scratching or a bump, can break it open, resulting in an ulcer. Ulcers may also develop without any known injury, typically on the inside of the ankle. Ulcers are usually only slightly uncomfortable. A very painful ulcer might be infected. Chronic venous insufficiency causes the skin to be discolored and to develop scaling, weeping, and crusting. The changes are easily visible in people with light-skin (top) and people with dark-skin (bottom). Images provided by Thomas Habif, MD. Venous stasis causes the skin to become hard and leathery and darker than the surrounding skin. A shallow ulcer is developing at the ankle. © Springer Science+Business Media In this photo of a person with stasis dermatitis, the skin is broken down, forming an open sore (ulcer). Image provided by Thomas Habif, MD. This large venous stasis ulcer is surrounded by reddish brown skin. © Springer Science+Business Media If edema is severe and persistent, scar tissue develops and traps fluid in the tissues. As a result, the calf permanently enlarges and feels hard. In such cases, ulcers are more likely to develop, and they heal less easily. 