Last week we discussed PAD and the non-invasive vascular studies that can be completed in our office to help with diagnosing PAD. Through the BioMedix Collaborative Care Network, communication between your medical team can be facilitated. Chronic Venous Insufficiency (CVI) is another vascular related problem (covered on the BioMedix Website) that non-invasive vascular studies can help to diagnose, but it differs from Peripheral Arterial Disease in its location within the body’s blood vessels. As the name implies, CVI is a condition that results from damage to the veins or venous flow within the body, where as we learned last week, PAD is disease of the arteries.
Veins located throughout the body are responsible for bringing blood from locations furthest from the heart back up to the heart, for recycling and re-oxygenation by the lungs. This prepares the blood to again circulate through the body and carry oxygen out to the tissues. Located within the bodies veins are tiny one-way valves which when the blood is being transported back up to the heart, help pump the blood upwards while closing off with each beat of the heart to prevent backflow of the blood with gravity. When those valves become damaged, patients suffer from Chronic Venous Insufficiency, where the body has difficulty pumping blood through its veins back up towards the heart.
Patients will slowly notice an onset of symptoms including painful, swollen and “heavy feeling” legs. They will notice that their legs begin to feel tired or restless at the end of a long day, which is something they have not experienced before. In addition, patients may start to notice varicose veins and veins bulging through the skin as the pressure building up within them predisposes them to enlargement.
Other associated symptoms and conditions may include skin discoloration, dry scaly skin along the legs and feet and breakdown of the skin if the buildup of extra fluid in the legs becomes too great. Breakdown of the skin typically presents in the form of a “Venous Stasis Ulceration,” which basically means what we’ve been saying: the ulceration is caused by blood located within the venous system of the body that is stuck in the legs and leads to ulceration.
Risk factors for the development of CVI are varied, but some can depend largely on hereditary and the nature of the patient, meaning those that have a family history of CVI or are women over the age of 30 are at a greater risk for development. In addition, patients with a history of blood clots, multiple pregnancies or who do lots of heavy lifting and endure long periods of standing also have an increased risk.
If you present to your Podiatrist with a variety of the risk factors and symptoms consistent with Chronic Venous Insufficiency, your diagnosis may be made by clinical examination alone. However, it is important to undergo Vein Studies to help rule out any larger problems, such as blood clots, in addition to selecting the most appropriate treatment regimen.
We mentioned last week that Advanced Footcare Centers LLP collaborates with BioMedix through a Collaborative Care Network, where vascular testing can be completed and communication can electronically occur between your medical team (Podiatrist, Primary Care Physician and Vascular Surgeons). In addition to including testing for Peripheral Arterial Disease, BioMedix also collaborates on testing and treating Chronic Venous Insufficiency.
The most accurate test is called a Venous Duplex Ultrasound. The test takes an ultrasonic picture of the veins in the body to detect any acute or chronic blockages in addition to evaluating the status of your veins one-way valves. Once any acute blood clot has been ruled out and Chronic Venous Insufficiency has been diagnosed, there are a variety of treatment options available. Some treatments can be done by you at home, such as maintaining a healthy diet and exercising regularly to increase the competency of your legs muscle pump to help bring blood back to the hear easier. Compression stockings are often encouraged for patients without any history of congestive heart failure and for those patients that stand for long periods of time, as the compression will help the legs bring blood back up towards the heart rather than becoming stuck in the legs. Medications such as diuretics can be used to decrease some of the fluid build-up, but as always, before any of these treatments are initiated, consult your Podiatrist and your Primary Care Physician.
For more information on Chronic Venous Insufficiency, please click on the link below, which will direct you to the BioMedix Collaborative Care Network!