Is There a Link Between Dorsal Vein Distension and Deep Vein Thrombosis?

Is there a strong association between dorsal venous dilation and deep vein thrombosis?

Hello, doctor.
I previously visited a vascular specialist for an ultrasound, and the doctor informed me that there was only mild reflux in my left leg.
The recommendation was to wear compression stockings when sitting or standing for long periods.
After wearing them, the veins on the dorsum of my foot became less prominent, sometimes appearing only as faint traces on the skin.
However, I recently noticed that while wearing the compression stockings, my foot sometimes heats up, and upon inspection, the dorsal veins still appear engorged.
Strangely, there are times in the afternoon when my foot swells and feels warm, but by evening, it returns to normal, feeling cool.
Once, around 5 PM to 6 PM, my foot suddenly became cold, and when I checked, the veins had diminished, leaving only traces without any swelling.
Is this a normal physiological phenomenon? Is it common for blood circulation to fluctuate like this? During these episodes, while sitting, my left leg experiences a sensation similar to the discomfort from prolonged sitting, extending from my buttocks to the mid-thigh, and my calf also feels slightly numb.
Could this be related to deep vein thrombosis? I have concerns because during these episodes, I experienced a week of insufficient sleep, which led to feelings of chest tightness, difficulty breathing, and increased heart rate.
When taking deep breaths, I felt a slight pain near my left armpit.
I attributed this to lack of sleep, but it is a phenomenon I hadn’t experienced before despite staying up late.
Given the recurrence of the dorsal vein issues, I wonder if there could be a connection between these two situations.

jim, 20~29 year old female. Ask Date: 2020/12/25

Dr. Cai Guiqin reply Cardiology

It is recommended that you discuss the above situation with your attending physician to determine if further examinations are necessary.
Thank you, and wish you good health!

Reply Date: 2020/12/25

More Info

The symptoms you are experiencing, including dorsal vein distension, localized warmth, and sensations of heaviness or numbness in your leg, can be concerning, especially given your history of prolonged sitting and standing. However, based on the information provided, it is unlikely that these symptoms are directly indicative of deep vein thrombosis (DVT).

Deep vein thrombosis is a condition where a blood clot forms in a deep vein, typically in the legs. Common symptoms of DVT include swelling, pain, tenderness, and warmth in the affected leg. The pain is often described as a cramp or soreness, and the swelling may be significant. In contrast, your description of the veins appearing distended only intermittently, along with the absence of persistent swelling or pain, suggests that your condition may be more related to venous insufficiency or varicose veins rather than DVT.

Venous insufficiency occurs when the veins struggle to send blood back to the heart, often due to weakened valves. This can lead to symptoms such as swelling, heaviness, and visible distension of superficial veins, particularly after prolonged periods of sitting or standing. The use of compression stockings, as recommended by your physician, is a common treatment for this condition, as they help improve blood flow and reduce swelling.

The phenomenon of your veins distending and then returning to normal could be a result of changes in blood flow dynamics, particularly with temperature fluctuations. When your legs get warm, blood vessels naturally dilate, which can lead to increased blood flow and temporary distension of the veins. Conversely, when your legs cool down, the veins may constrict, leading to a reduction in size and a return to a more normal appearance. This is a normal physiological response and does not necessarily indicate a pathological condition.

Regarding your concerns about the sensations in your thigh and calf, these could be attributed to a variety of factors, including muscle fatigue, nerve compression, or even anxiety related to your symptoms. The feeling of heaviness or discomfort that extends from your buttocks to your thigh could be related to prolonged sitting, which can lead to muscle strain or nerve irritation. If you have been experiencing sleep disturbances and increased stress, these factors can also contribute to physical symptoms, including muscle tension and discomfort.

It is important to monitor your symptoms and maintain open communication with your healthcare provider. If you notice any new symptoms, such as persistent swelling, significant pain, or changes in skin color, it would be prudent to seek further evaluation. Additionally, if you have concerns about DVT, especially following long periods of immobility (such as long flights), it may be beneficial to discuss these concerns with your doctor, who may recommend further testing or preventive measures.

In summary, while dorsal vein distension can be concerning, it is more likely related to venous insufficiency rather than DVT, especially given the intermittent nature of your symptoms. Maintaining an active lifestyle, using compression stockings, and ensuring proper hydration can help manage your symptoms. If your symptoms persist or worsen, further evaluation by a vascular specialist may be warranted to rule out any underlying conditions.

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