Suspicion of vein valve dysfunction is obvious if the legs are heavy, the lower legs swell, nocturnal leg cramps occur, and larger veins are visible or even form lumps.

Many patients consult a dermatologist directly, as skin changes such as very itchy eczema, swelling and pigmentation are often the main symptoms. Symptoms can be clarified through medical history, physical examination and some non-invasive measurement procedures. This is particularly important because heart disease, thyroid disease, kidney disease, lymphatic drainage, and other metabolic disorders can also cause leg swelling.

As part of medical diagnosis, the function of the venous valve is examined using ultrasound examination. Light reflection rheography can be used to make a statement about the conditions of venous return. Both examination procedures are not painful or stressful for the patient and are very informative. Depending on the results of the tests, surgical therapy, sclerotherapy or, if necessary, laser therapy should be preferred. If surgery is not possible and venous function is restricted, a compression bandage may improve or normalize venous blood return.

Open legs can also be the result of venous disease, mainly or in combination with arterial circulatory disorders or diabetes and heart failure. Often, no venous dysfunction is found in patients with spider veins or an enlarged venous pattern. If desired, venous sclerotherapy can be performed for aesthetic reasons. In summary, we can say: venous diseases are very common. Early diagnosis and therapy can prevent consequential damage and spare suffering. During the clarification, the patient discovers whether it is just an aesthetic problem or a disease that requires treatment.

How veins work

While blood is pumped into the blood vessels by the heart and distributed into smaller and smaller blood vessels, after supplying the cells it accumulates again in small veins, which pass it on to larger and larger veins until it reaches the heart again via the large vein. dig. Blood is pumped to the lungs through the right ventricle, saturated with oxygen, and ejected again through the left ventricle and aorta into the arterial circulation. For venous blood to return to the heart, several pumping and suction mechanisms are necessary. In addition to the suction effect of the heart and the pressure difference caused by breathing, muscular tension in the venous wall of the large veins and, mainly, in the muscular pump also contribute to the reflux process. Similar to the way a wet bar of soap moves in the hand under pressure, the blood in the veins moves under the pressure of the surrounding leg muscles. This is already possible when the body is at rest, as the muscles have a certain state of tension (muscle tone). During physical exercise, this process is further intensified by muscle contraction.

For the calf muscles to be used properly, the feet must have an intact rolling motion. Due to osteoarthritis or high-heeled shoes, the natural rolling motion in the ankle joint is impaired. Due to the arrangement of the venous valves in the vein sections, the blood can only advance in a unilateral direction, i.e. towards the heart. Reflow towards the foot is generally not possible, as the functional pocket flaps prevent this by closing the flaps in a timely manner.

Complaints: from itching to open leg

Venous return disorders can lead to a symptom complex due to venous thrombosis (secondary varicose veins) or venous insufficiency due to a predisposed venous disease (primary varicose veins), which is referred to as chronic venous insufficiency (insufficiency = poor performance). The following symptoms may occur: Visible venous cords on one or both legs; easy leg fatigue, feeling of heaviness, burning in the soles of the feet, increased discomfort when sitting or standing, improvement when running. If water edema persists for a long time, the skin hardens and calluses (dermatosclerosis), pigment formation and stasis eczema occur, which is scratched due to intense itching. Bacterial infections promote the development of the first small ulcers, which do not heal due to congestion and enlarge. The dreaded “open leg” (ulcus cruris) occurs. For the affected patient, there is not only physical suffering, but also psychological suffering, as social relationships and the performance of professional activities are also tense or at risk.

Deep vein thrombosis

Deep vein thrombosis in the leg veins is particularly feared and dangerous and can trigger a potentially fatal pulmonary embolism. Suspicion arises if pressure pain occurs on one side of the leg within a few hours, in the calf or thigh region. As a result, femoral vein thrombosis leads to an accumulation of fluid in the leg region, accompanied by considerable pressure pain. If detected in a timely manner, initial vein function can be maintained through hospitalization and successful therapy. If valve damage has already occurred in the veins, venous function will remain damaged for life. The clinical picture of post-thrombotic syndrome appears.