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    Vascular Diseases and Pain

    Varicose Veins

    Varicose veins are bulging, swollen, purple, ropy veins, seen just under your skin, caused by damaged valves within the veins. They are more common in women than men and often run in families. They can also be caused by pregnancy, being severely overweight, or by standing for long periods of time. The symptoms include:

    • Bulging, swollen, purple, ropy, veins seen under the skin
    • Spider veins -- small red or purple bursts on your knees, calves, or thighs, caused by swollen capillaries (small blood vessels)
    • Aching, stinging, or swelling of the legs at the end of the day

    Blood Clots In the Veins

    Blood clots in the veins are usually caused by:

    • Long bed rest and/or immobility
    • Damage to veins from injury or infection
    • Damage to the valves in the vein, causing pooling near the valve flaps
    • Pregnancy and hormones (such as estrogen or birth control pills)
    • Genetic disorders
    • Conditions causing slowed blood flow or thicker blood, such as congestive heart failure (CHF) or certain tumors

    There are many types of blood clots that can occur in the veins:

    • Deep vein thrombosis (DVT) is a blood clot occurring in a deep vein.
    • Pulmonary embolism is a blood clot that breaks loose from a vein and travels to the lungs.
    • Chronic venous insufficiency isn't a blood clot, but a condition that occurs when damaged vein valves or a DVT causes long-term pooling of blood and swelling in the legs. If uncontrolled, fluid will leak into the surrounding tissues in the ankles and feet, and may eventually cause skin breakdown and ulceration.

    Blood Clotting Disorders

    Blood clotting disorders are conditions that make the blood more likely to form blood clots in the arteries and veins. These conditions may be inherited (congenital, occurring at birth) or acquired and include:

    • Elevated levels of factors in the blood which cause blood to clot (fibrinogen, factor VIII, prothrombin)
    • Deficiency of natural anticoagulant (blood-thinning) proteins (antithrombin, protein C, protein S)
    • Elevated blood counts
    • Abnormal fibrinolysis (the breakdown of fibrin)
    • Abnormal changes in the lining of the blood vessels (endothelium)

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