Varicose Veins

Question 1

Define varicose veins.

Answer 1

Varicose veins are subcutaneous, permanently dilated veins 3 mm or more in diameter when measured in a standing position.

Question 2

Explain the aetiology/risk factors of varicose veins.

Answer 2

Increasing numbers of births
DVT
Occupation with prolonged standing
Obesity

Question 3

Summarise the epidemiology of varicose veins.

Answer 3

Prevalence estimates vary based on population, selection criteria, disease definition, and imaging techniques. Generally, prevalence rates are higher in industrialised countries and in more developed regions.

Question 4

Recognise the presenting symptoms of varicose veins.

Answer 4

Dilated tortuous veins
Leg fatigue or aching with prolonged standing
Leg cramps
Restless legs

Question 5

Recognise the signs of varicose veins on physical examination.

Answer 5

Haemosiderin deposition
Corona phlebectatica

Question 6

Identify appropriate investigations for varicose veins and interpret the results.

Answer 6

Duplex ultrasound

Question 7

Generate a management plan for varicose veins.

Answer 7

Patients should also be counselled on lifestyle modifications including weight loss, leg elevation, and exercise. Use of compression stockings can also help the physician and patient to determine whether symptoms are truly related to varicosities.

Question 8

Identify the possible complications of varicose veins and its management.

Answer 8

Chronic venous insufficiency
Haemorrhage
Venous ulceration
Lipodermatosclerosis
Haemosiderin deposition

Question 9

Summarise the prognosis for patients with varicose veins.

Answer 9

Although there are small variations in overall efficacy depending on the type of intervention, generally resolution of symptoms occurs in >95% of patients. However, patients need to be counselled that new varicosities will very likely occur with time.