Varicose Veins: Symptoms, Causes, and Treatment Options

Acute onset of varicose veins?

Hello Doctor: Four months ago, after a long day of standing and walking during an outing, I realized that I may not have consumed enough fluids.
Upon returning home, I experienced discomfort in my left calf, and a few days later, I suddenly noticed varicose veins in my left leg (without any protruding veins).
Subsequently, I often felt a vague soreness in my left leg, accompanied by intermittent sharp pain, as well as a peculiar pulsating sensation that started from behind my knee and, after exercise and massage, moved to my thigh and groin area.
This pulsating sensation occasionally comes with sharp pain, creating a feeling of something being stuck.
Additionally, I experience occasional sharp pain in the center of my chest when I cough.

Concerned about the possibility of thrombosis, I visited a hospital for evaluation.
My D-dimer level was 211, and a deep vein ultrasound showed no issues.
The venous outflow/venous capacitance (VO/VC) was at 68%, indicating mild reflux symptoms, but the doctor deemed it acceptable and ruled out deep vein thrombosis, considering my legs to be normal and attributing the condition to simple varicose veins, which were so mild that no treatment was necessary.
However, the sharp pain in my groin persists, as does the occasional chest pain and the soreness and sharp pain in my leg.

I would like to ask if this could be caused by a "mild" embolism, and whether it can be treated or absorbed by the body on its own? Or could it be indicative of another issue? Thank you, Doctor, for taking the time to read this; this issue has been troubling me for a long time.
Thank you.

Xinqing Yumen Zhe, 20~29 year old female. Ask Date: 2024/01/18

Dr. Wu Xueming reply Cardiology

Based on the examination report you described, your symptoms are not caused by deep vein thrombosis.
Regarding the phenomenon of varicose veins, if it is mild, it is advisable to avoid prolonged sitting or standing.
You may also wear compression stockings to enhance venous return when necessary.
If the condition is severe and does not improve, you may need to visit a cardiothoracic surgery outpatient clinic for treatment.

Reply Date: 2024/01/18

More Info

Varicose veins, or varicosities, are enlarged, twisted veins that often appear on the legs and feet. They can cause a variety of symptoms and may be associated with underlying health issues. Understanding the symptoms, causes, and treatment options for varicose veins is crucial for managing this condition effectively.

Symptoms of Varicose Veins
The symptoms of varicose veins can vary from person to person, but common signs include:
1. Visible Veins: The most apparent symptom is the appearance of swollen, twisted veins that are often blue or dark purple.

2. Pain or Discomfort: Many individuals report aching, heaviness, or a feeling of fullness in the legs, especially after prolonged standing or sitting.

3. Swelling: The legs may swell, particularly around the ankles, after long periods of standing.

4. Itching or Burning Sensation: Some may experience itching or a burning sensation around the affected veins.

5. Skin Changes: Over time, varicose veins can lead to changes in skin color, texture, and even the development of ulcers or sores.

Causes of Varicose Veins
Varicose veins occur when the valves in the veins that help blood flow back to the heart become weak or damaged. This can lead to blood pooling in the veins, causing them to enlarge. Several factors can contribute to the development of varicose veins:
1. Genetics: A family history of varicose veins increases the likelihood of developing them.

2. Age: As people age, the valves in their veins can weaken, leading to varicosities.

3. Gender: Women are more likely to develop varicose veins, possibly due to hormonal changes during pregnancy, menstruation, or menopause.

4. Obesity: Excess weight puts additional pressure on the veins in the legs.

5. Prolonged Standing or Sitting: Occupations that require long periods of standing or sitting can increase the risk of developing varicose veins.

Treatment Options
Treatment for varicose veins depends on the severity of the condition and the symptoms experienced. Options include:
1. Lifestyle Changes: Simple changes such as regular exercise, maintaining a healthy weight, and elevating the legs can help alleviate symptoms.

2. Compression Stockings: Wearing compression stockings can help improve blood flow and reduce swelling.

3. Sclerotherapy: This minimally invasive procedure involves injecting a solution into the varicose veins, causing them to collapse and fade.

4. Laser Treatments: Laser therapy can be used to close off smaller varicose veins and spider veins.

5. Vein Stripping: In more severe cases, surgical removal of the affected veins may be necessary.

Concerns About Symptoms
In your case, the symptoms you describe, such as the pulsing sensation and intermittent pain in the groin and chest, warrant further investigation. While your D-dimer levels and ultrasound results ruled out deep vein thrombosis (DVT), it is essential to consider other potential causes for your discomfort.
The sensation of a pulse or pain in the groin could be related to nerve irritation or musculoskeletal issues rather than a vascular problem. Additionally, the chest pain you experience could be due to anxiety, muscle strain, or other non-cardiac causes, especially if it occurs intermittently and is not associated with exertion.

Conclusion
While varicose veins can lead to discomfort and cosmetic concerns, they are often manageable with lifestyle changes and medical interventions. Given your ongoing symptoms, it would be prudent to follow up with your healthcare provider for a comprehensive evaluation. They may consider additional imaging studies or referrals to specialists, such as a vascular surgeon or a cardiologist, to ensure that all potential causes of your symptoms are explored. Remember, early intervention can help prevent complications and improve your quality of life.

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