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Venous Insufficiency

Venous Insufficiency is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Inadequacy of the venous valves that causes impaired venous drainage leading to edema of the lower extremities.
  • A chronic condition of lower extremity vascular incompetence.
  • Normal blood flow in the venous system is unidirectional from the superficial veins to the deep veins.
  • Unidirectional flow is maintained by contraction of leg muscles and by valves within the veins.
  • Damage to the valves, e.g. following DVT, causes them to become rigid and they lose their ability to prevent retrograde blood flow properly.
  • Decreased venous return from lower extremities causes increased pressure and distention of the veins, which in turn causes separation of the valve leaflets.
  • Increased pressure transmitted into the dermal microcirculation results in extravasation of macromolecules and red blood cells causing inflammatory injury resulting in ulcer formation, skin changes, and poor ulcer healing.

Etiology

  • Primary valve incompetence (most common)
  • Deep vein thrombosis (DVT)
  • Risk factors include advanced age, family history, smoking, sedentary lifestyle, obesity, lower extremity trauma, prior DVT, and pregnancy

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Citation

Rosen, Peter, et al., editors. "Venous Insufficiency." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307320/all/Venous_Insufficiency.
Venous Insufficiency. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307320/all/Venous_Insufficiency. Accessed April 26, 2019.
Venous Insufficiency. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307320/all/Venous_Insufficiency
Venous Insufficiency [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307320/all/Venous_Insufficiency.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Venous Insufficiency ID - 307320 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307320/all/Venous_Insufficiency PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -