HealthVaricose Veins and Blood Clot Risk: Understanding the Connection

Varicose Veins and Blood Clot Risk: Understanding the Connection

Contrary to popular belief, varicose veins are not always a condition that affects the elderly. In some cases, individuals who are otherwise in good health can develop varicose veins. Women are also more likely to develop the condition compared to men. In any case, a person who has developed a varicose vein should not be overly concerned about their general health, as a varicose vein is seldom an indicator of a serious medical problem. Unhealthy veins in the legs are caused when valves in the vein are unable to pump blood back to the heart in a proper manner. This leads to the blood pooling in the vein, and the vein is then put under higher pressure from the constant force of gravity. This is what causes the vein to become twisted and is what gives the vein its swollen and painful characteristics.

The first step in educating the public about varicose veins and blood clot risk is to define what a varicose vein is. By knowing what a varicose vein actually is and not accepting the “old wives’ tale,” might deter individuals from taking unnecessary action to treat a condition that is of little threat to their health. A varicose vein is easy to define. It is simply a vein, usually in the leg, that has become swollen or twisted. Usually, a varicose vein has a purplish color and often looks like a piece of rope that is bulging from the skin. Often, individuals with varicose veins will experience the legs feeling heavy or get cramping or swelling in the lower legs and ankles. Depending on the severity of the condition, some individuals might not experience any pain at all.

This essay serves to inform and educate the general population about the connection between varicose veins and the risk of developing a blood clot. It also aims to dispel several myths that are abundant in society regarding this issue, myths that could be very dangerous to those who are misinformed. The intended audience of the essay are those individuals who have varicose veins and are concerned about their possible escalation to a more serious condition. It is hoped that by reading this paper, visitors will gain a clear understanding of varicose veins, blood clots, and most importantly, how the two conditions are connected. Reading this paper may save individuals from unnecessary worry or possibly even prevent a serious health issue from developing in the future.

Causes of Varicose Veins

Pregnancy is another common cause of varicose veins. During pregnancy, a woman’s blood volume increases, but the flow of blood from the legs to the pelvis decreases. This can cause an increase in pressure on the veins in the legs, which can lead to varicose veins. Hormonal changes during pregnancy can also cause the walls of the veins to weaken without the loss of elasticity, which can cause varicose veins. Changes in hormone levels can also relax the vein walls, which can also lead to varicose veins. Usually, varicose veins that occur during pregnancy will improve within 3-12 months after delivery.

Varicose veins can occur as a result of several different factors. The most common is genetics. If other family members suffer from varicose veins, then there is a good chance that you will too. There are many different genetic factors that can cause varicose veins. Research has shown that weakness of the veins or valves can cause varicose veins. Weak vein walls can cause the vein to lose its elasticity, which can cause pooling of the blood. If this occurs, then the vein will become swollen and cause varicose veins to appear. If the valves in the veins are not functioning properly, then blood can flow in the wrong direction. This can cause the veins to become swollen.

Genetic Factors

The most recent work demonstrates with considerable clarity that heredity may be the most important factor in the development of varicose veins or severe chronic venous diseases. Family history represents anamnesis of the past in medical terms. Several full reviews of patient populations have inquired into the family history of people with or without venous diseases. Most indicative is the data of 578 sequential patients evaluated over a seven-year period. 344 of these noted the onset of their venous problems prior to age 40 and were determined to have primary rather than secondary or post-thrombotic disease. Of these 344, 83% reported a positive family history of venous disorders. These data have been statistically analyzed, confirming the increased likelihood of a positive family history in those with primary venous disease compared to those with other or unrelated chief complaints. The remainder of the 578 patients whose venous disease began after age 40 had a similar but less impressive increased incidence of familial venous disease compared to non-venous patients. More data was obtained by surveying patients and controls with specific gynecologic or male reproductive disorders and evaluating the subsequent family history. These data also confirmed an increased prevalence of venous disease in relatives. These methods have helped to prove that familial venous diseases are so variable that simple Mendelian inheritance cannot be used to explain them.


The pressure on pelvic veins also plays a major role in the development of varicose veins on the legs, as these veins carry blood up from the legs and are already working against gravity. This pressure can lead to the pooling of blood in the leg veins. Women who have had multiple pregnancies or have had a single pregnancy with multiples are at particular risk for developing varicose veins that require treatment.

Changes in hormone levels are especially important because they cause the relaxation of the vein walls. The hormone progesterone works to do this, as do the ovarian hormones estrogen and perhaps even the hormone hCG. These hormones begin to affect the vein walls in the first trimester and their effects are cumulative over time. This is why it is common to see varicose veins in pregnant women with each additional pregnancy.

Pregnancy plays a major role in the formation of varicose veins. Changes in hormone levels, beginning from the first trimester, relax the vein walls. The expanding uterus also puts increased pressure on the pelvic veins. There is also increased volume of blood in the body. All of these changes are designed to help support the growth and delivery of the baby, but can also result in increased varicose veins.

Age and Gender

Pregnant women are particularly vulnerable because pregnancy increases the volume of blood in the body but decreases the flow of blood from the legs to the pelvis. This change is designed to support the growing fetus, but it can produce an adverse effect—the enlarged uterus puts pressure on the veins in the pelvis, slowing the flow of blood from the legs. Varicose veins often form on the legs during pregnancy. The good news is that they often improve within 3 months after delivery. Elevation of the legs and wearing support hose can help to relieve the problem.

Older people are at risk for chronic venous insufficiency and varicose veins because the valves in their veins may weaken and not work as well. Blood can then flow backwards and pool in the lower legs. This is more likely to happen if you are older. Chronic venous insufficiency and varicose veins are more common in women than in men. They are also more common in people who are in certain professions that require a lot of standing, such as nurses, store clerks, and teachers. Hormonal factors including puberty, pregnancy, menopause, the use of birth control pills, and hormone replacement can raise a woman’s risk for chronic venous insufficiency and varicose veins.

Symptoms and Complications of Varicose Veins

Leg pain and swelling – venous reflux is the next symptom of varicose veins. Sufferers typically experience both acute throbbing and/or a prolonged dull ache in the legs. Leg pain may be caused by muscle cramps or fatigue over an extended period of time. The pain typically subsides with leg elevation and/or the use of anti-inflammatory medications. Pain at night with leg involuntary movements. Repeatedly, patients may state that the pain doesn’t feel like it’s coming from the joints and/or muscles but deep inside their legs.

Visible veins and skin discoloration – a visible sign of veins at the body. Academic year declaration usually starts with the spidery blue-greenish veins on the floor of the foot. The vein then progressively enlarges and lengthens. Symptoms associated with visual varicose veins encompass aching aches with prolonged status and ugly leg sensations. If severe, skin changes can occur such as dry, thin, brittle skin that might possibly cause skin cuts and irritation. Skin color will change close to the vicinity due to extended strain in the area. The affected skin can turn dark brown, purple, and/or a reddish color. These changes can be irreversible.

Visible Veins and Skin Discoloration

The red blood cells in the veins affected by venous reflux can give the skin a red or brown color. This happens because the red blood cells leak from the affected veins into the surrounding tissue of the lower leg. Ironically, the very process by which the body attempts to heal the resulting tissue damage can lead to further damage and skin problems. This is because the body responds to the tissue damage with an increased production of white blood cells. Over time, some of these white blood cells can convert into cells called fibroblasts. Fibroblasts produce substances that give the skin a tougher, more leathery appearance. If too many fibroblasts form, the skin can become inflamed and itchy. This is a condition known as stasis dermatitis. In severe cases, the skin around the ankles can break down and form open sores or ulcers.

One of the most common and obvious symptoms of varicose veins is the rope-like, bluish appearance of the veins themselves. This is especially likely with larger veins, usually on the legs. Additionally, skin in areas near the affected veins may be discolored, taking on a red or ruddy brown appearance. These visible signs often cause a great deal of consternation and worry about one’s appearance. This is particularly true in those who work in professions requiring shorts or dresses.

Leg Pain and Swelling

Other forms of leg pain may be the result of more severe vein disorders. A chronic build-up of tissue fluid can cause a painful swelling of the entire lower leg. The skin in this area can become shiny and discolored, and further neglect of the condition can cause the skin to peel. An acute form of this swelling, known as venous claudication, is caused by a temporary cessation of blood flow to the muscle. This can cause intense cramping pain which will subside once the patient has rested.

The process of blood being reabsorbed by the body can cause some discomfort. Swollen varicose veins can be tender to the touch and can cause aching in the affected limb. This pain tends to be exacerbated after standing for long periods of time and can be relieved by elevating the leg or by using compression stockings. Pain caused by varicose veins can limit the activity of some individuals as they attempt to avoid the pain. This lack of movement can lead to other forms of leg pain.

Ulcers and Skin Infections

Ulcers result from long-term fluid buildup in the tissues, caused by the increased back pressure from the incompetent valve. This in turn can cause chronic skin inflammation, leading to skin changes and ultimately ulcers. It is helpful to understand the difference between the three common types of leg ulceration. A brownish staining near the ankle, often accompanied by a small patch of irritated skin may be a sign of potential ulceration caused by chronic venous insufficiency. This is usually fairly superficial and with treatment, can be healed without venous surgery. An active, painful sore that looks infected and has red streaking may be a sign of a more serious skin infection. If not treated promptly, this could develop into a large, open, draining sore known as an ulcer, and it will likely heal only if the vein causing the underlying problem is treated. The least common type of ulceration is due to a ruptured varicose vein. This is a sudden event with a lot of blood loss that usually requires medical attention. It is a misconception to think that varicose veins are only a cosmetic problem. Eczema is also a sign of chronic skin inflammation and irritation. Usually the skin becomes red, irritated and itchy, often in the area by the ankle. Prompt treatment of this type of skin irritation can prevent progression to ulceration.

Varicose Veins and Blood Clot Risk

We now understand that blood within the normal veins of the legs is propelled towards the heart by the calf muscle pump and is then pumped to the lungs for oxygenation before being returned to the heart and pumped to the rest of the body. This one-way flow of blood to the heart is made possible by a complex system of valves within the veins. Should these valves malfunction, blood begins to pool in the lower veins and the pressure within these veins increases. This increase in pressure is transmitted to the smaller surface veins and then to the more delicate capillaries. It is at this point that patients begin to notice symptoms such as leg heaviness, fatigue, and aching. These symptoms are all indicative of a process called venous hypertension in which the increase in pressure in the leg veins is transmitted to the surrounding tissues. Persistent high pressures within the veins can have adverse effects on the skin and its underlying tissues. This can lead to the skin becoming brown in color due to iron deposits from the blood, the development of eczema, and in severe cases, an ulcer may develop on the inside of the ankle. Ulcers are difficult to heal and have a high chance of recurrence if the underlying venous cause is not corrected. High pressures in the veins can also cause them to become varicose. High pressure in the deep veins of the leg has already been identified as a risk factor for DVT. This indicates that patients with superficial venous reflux and varicose veins are at risk of clot formation in the superficial veins.

Understanding the Link

Although there is a higher risk for people with severe varicose veins to develop blood clots, it is important to note that prevention of varicose veins in the first case is the best plan of attack. This means early on in the development of varicose veins, people should do all they can to reduce venous stasis and decrease the severity of the varicose veins. This can be achieved through regular exercise, elevating the legs, losing weight, or wearing compression stockings. By reducing venous stasis and the severity of varicose veins, people can largely reduce the risk of blood clot formation.

Varicose veins are enlarged, twisted veins usually found in legs and are a result of venous insufficiency. This insufficiency can cause venous stasis, a state in which blood does not move from the veins into the heart as efficiently as it should. This inefficiency increases the chances of blood clotting for various reasons, which can then lead to more serious conditions such as DVT or PE. Understanding the link between varicose veins and the increased risk of blood clot formation provides people suffering from varicose veins an opportunity to prevent the formation of blood clots and more serious conditions.

Deep Vein Thrombosis (DVT)

Acute DVT commonly presents as a painful swollen leg. Left untreated, two-thirds of patients will develop post-thrombotic symptoms such as venous eczema, skin discoloration, lipodermatosclerosis, or even a venous ulcer. These symptoms collectively are known as post-thrombotic syndrome and can cause major disability. Chronic DVT that has gone undetected for a long period of time can present in unusual ways as the thrombus acts as a space-occupying lesion that over time is replaced by fibrous tissue. A case of May-Thurner syndrome, where the left common iliac vein is compressed by the right common iliac artery against the spine causing it to become almost completely occluded, was discovered incidentally during a varicose vein operation in a patient presenting with varicose veins of the left leg and an unusual pattern of superficial and deep vein reflux.

A review of an article in the journal Phlebology reported a belief by the public and many healthcare workers that DVT is caused by long-haul flights and international travel. While it is true that travel can exacerbate DVT in those already suffering from the condition, the real cause is chronic venous insufficiency caused by superficial reflux disease. This review also reported that more public education is required worldwide to teach the link between chronic venous disease and DVT, as many see varicose veins as a cosmetic problem only and are not aware of the potential life-threatening complications.

The most serious vein-related disorder caused by high pressure in the great saphenous vein due to valve reflux and persistent venous hypertension is deep vein thrombosis or DVT. DVT is the development of a thrombus in the deep venous system, and if left untreated, it can cause major disability due to post-phlebitic syndrome or can be fatal if a pulmonary embolism results.

Pulmonary Embolism (PE)

A cohort study showed that there was a 50% increased risk of death in the first 3 months following a diagnosis of PE compared to those without PE. This increased death rate was due to the direct importance of PE as a principal cause of death and also because of fatal consequences due to delay in initiating effective treatment of the life-threatening lung clot.

It was traditionally believed that ibuprofen, an anti-inflammatory drug, could inhibit the growth of blood clots and help dissolve DVT directly. However, it is now known that such drugs may, in fact, have adverse consequences by thinning the blood and increasing the potential for blood clot migration to the lungs. PE due to migration of clots from existing DVT can result in a first-time diagnosis of DVT due to the apparent lack of symptoms of the original DVT episode. This can have serious repercussions in terms of patient prognosis.

Inadequate, partial blockage of the pulmonary artery is typically without significant symptoms and can be difficult to diagnose. However, when a blood clot in a deep vein breaks free and travels through the right side of the heart to the lungs, it can cause acute pulmonary embolism with potentially fatal results. An immaturely diagnosed and uncontrolled deep vein thrombosis and/or pulmonary embolism can lead to post-thrombotic syndrome. This can cause chronic venous insufficiency and recurrent episodes of painful venous ulceration.

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