Varicose veins history and symptoms

Besides cosmetic problems, varicose veins are often painful, especially when standing or walking. They often itch, and scratching them can cause ulcers. The symptoms such as heaviness, aching, cramping, etc. are often due to venous hypertension. The symptoms are often worse at the starting of the disease, mild at the middle of the disease, and again worsen in the advanced stages of the disease. Patients often get used to having the symptoms and might need some thorough interviewing to get the information^[1].

• History of venous insufficiency( skin changes, ulcers, insufficiency at prior duplex USG, leg edema after prolonged standing etc.).
• Positive family history of similar/vascular disease.
• History of predisposing factors such as occupation, trauma, pregnancy, medication(OCPs), sports, etc.
• History of other vascular diseases.

• Aching, heavy legs (often worse at night and after prolonged standing; improved by walking or limb elevation).
• Ankle swelling especially after prolonged standing.
• A brownish-blue shiny skin discoloration around the veins.
• Skin over the vein may become dry, itchy and thin, leading to eczema (venous eczema).
• The skin may darken (stasis dermatitis), because of the waste products building up in the legs.
• Minor injuries to the area may bleed more than normal and/or take a long time to heal.
• Restless leg syndrome.^[2] Restless Leg Syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency.

• Rarely, there is a large amount of bleeding from a ruptured vein.
• In some people the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard.

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