Long-term blood stasis in the superficial veins of the lower limbs significantly increases venous pressure and leads to gradual expansion, damage to the vein walls and progressive failure. Initially, you can see the first calves and thighs of the crinkled "snakes" visible under the skin.
FROM THE LIMITS OF THE LEGS OF SI�?? BEGINS ...
How are varicose veins formed?
Excess liquid that does not lead through veins at the time from the intercellular space of the legs leads to edema. The perimeter of the limb above the ankle grows, the foot is not in the shoe, and the socks or stockings after removing leave a marked impression on the body. This is the feeling most of us know. If the symptoms are transient - they appear, for example, after a long standing on a hot day - such a transient venous insufficiency is not yet a symptom of the disease. However, in people with frequent microcirculatory disorders or after venous thrombosis, the edema is much heavier and has a recurrent character. They are often the cause of difficulties in walking and in the performance of work as well as the harbinger of varicose veins.
When your legs swell and hurt - are you suffering from varicose veins?
The sign that something bad is happening with the circulation of blood in the legs is a feeling of weight in the limbs - usually felt after prolonged standing, especially on warm days. The appearance of ankle edema in the evening is a typical harbinger of microcirculation disorders. Edema is a sign that micro-veins (vein capillaries) and lymphatic vessels are unable to drain the surplus of intercellular fluid filtered between the vessels and tissues in the microcirculation. Frequent edema heralds the onset of varicose vein disease.
Microcirculatory disturbances and venous stasis
Venous stasis causes inflammation of the intravenous tissues and veins, which weaken the vessel walls and damage the valves. They also cause an increase in blood pressure in the lower veins - which extends and distorts microvessels. There are damaged capillaries - so-called spider veins. Then there is a growing weight in the legs, especially after all-day walking or long standing. It also increases the permeability of microvessels for blood plasma. Hence, swelling and pain in the legs, especially after prolonged standing or walking.
Causes of leg edema:
- microcirculation disorder due to general failure of blood circulation, eg atherosclerosis
- an outbreak of thrombosis in the veins (if superficial vein thrombosis gives rise to strong pain and usually does not escape the patient's attention, changes in deep vessels may occur without obvious symptoms and cause serious congestion)
- post-thrombotic syndrome
- pregnancy, obesity
- pressure on lymphatic vessels (enlargement of nodes, tumors)
- varicose veins as so-called feedback pathologically acting on the veins
Swelling due to microcirculation disorders
For intensified filtration of liquid blood plasma, the income in microcirculation disorders - caused by general heart failure, hormonal disorders, pregnancy or severe trauma. Excess fluid accumulating in the tissues leads to swelling and inflammation. The perimeter of the limb above the ankle grows, the foot is not in the shoe, and the socks or stockings after removing leave a marked impression on the body. There may be local painful redness, fever.
Outbreaks of thrombosis in the veins
The areas of blood stagnation and foci of thrombosis occurring at varicose veins favor inflammation of the subcutaneous tissue. Then there is painful redness, fever and swelling. Inflammations also damage the venous valves.Treatment consists of applying cold compresses, anti-inflammatory drugs, a flexible band (in this way, not to increase the stagnation). In more severe cases, antibiotics are given.
Complications of thrombosis - edema
Excess fluid accumulating in the tissues leads to edema. The perimeter of the limb above the ankle grows, the foot is not in the shoe, and the socks or stockings after removing leave a marked impression on the body. This is the feeling most of us know. Transient venous insufficiency, especially after prolonged standing on a hot day, may not be a symptom of the disease. In people with varicose veins or after venous thrombosis, the edema is much heavier and has a recurrent character. They often cause difficulties in walking and in working.
Varicosa can become a starting point for inflammation
Slow and sometimes completely stopped blood flow leads to the formation of thrombi in the varicose veins. The thrombus is an ideal medium for bacteria that are slept in many tons of healthy people in the tonsils or the under-treated teeth. A superficial vein clot causes considerable complaints, giving rise to severe pain, redness of the skin and spongy thickening. It can also cause stasis causing leg edema.
Deep vein thrombosis and post-thrombotic syndrome
Deep vein thrombosis can cause so-called a post-thrombotic syndrome that degenerates and destroys the ability to pump blood through the veins up to the heart. Symptoms of post-thrombotic syndrome - induced m..in. through venous hypertension - there may be pain, swelling and ulcers in the legs.
LEG ATTACHMENT STAGE ON THE ROAD TO CROP
The reason for swelling of the legs, especially in the lower legs are most often:
- microcirculation disorders due to general circulatory failure
- decreasing, with age, the ability of the lymphatic system to excrete cellular metabolites.
- venous stasis caused by varicose veins,
- accidental injuries, injuries
Microcirculatory disorders and swelling of the legs
The most common cause of edema is microcirculation. The reason is general circulatory insufficiency (atherosclerosis), diabetes, accidental injuries and chronic immobilization. Most microcirculatory insufficiency leads to local blood stasis and accumulation of excess tissue fluid around the venous capillaries. It disturbs the microcirculation drastically - because in its area under normal conditions, "suction" and drainage of waste from cells (carbon dioxide, urea, etc.) into the venous and lymphatic systems. The disorder causes increased activity of the immune system and the production of numerous inflammatory substances.
Harmful substances in the blood
Many inflammatory substances (histamine, bradykinin, serotonin, prostaglandins) arising at the time of injury or allergic reaction increase the permeability of capillaries and cause excessive penetration of blood components into the intercellular fluid. The proteins are also filtered, and even in some cases blood elements, eg erythrocytes. The cause of capillary leakage may also be the enzyme hyaluronidase, an excess of toxic cell metabolites (carbon dioxide, urea, etc.); as well as substances formed in various pathological conditions, e.g. in diabetes or uremia. An excess of inflammatory and toxic substances results in perivascular inflammation and aggravation of microcirculation disorders, with "spillage" of liquid components of the plasma into the inter-tissue space. Excess tissue fluids cause the inability of their full "suction" to the venous system. It leads to a large accumulation of inflammatory and metabolic waste in this place. The result is swelling and progressive venous insufficiency.
"Sucking" the excess of intercellular fluid and pumping into the veins
For circulation, the veins return approximately 90% of the volume of the "filtrate" of cellular fluid from the capillaries. The remaining 10% returns to the bloodstream via the lymphatic vessels. If we trace the path of these 10% of the fluid flowing through the lymphatic vessels - we will notice that in the tissues, between the cells, there are so-called initial lymphatic vessels. They are porous, like a sieve and capable of absorbing fluid. These initial vessels can be "closed" or "open".They have relatively large holes through which not only intercellular fluid with the metabolites contained in them are sucked in, but also blood cells or other large morphotic elements found in the intercellular fluid. Intracellular fluid, entering the initial lymphatic vessel, forms the so-called lymph. Initial vessels combine with larger pooled lymph vessels. Conducted lymphatic vessels contain large "substance" substances and cells that can not be absorbed into the blood through venous capillaries called venous capillaries. Collective lymph vessels have so-called circular sphincter, performing worm movements. These movements cause suction of a significant amount of tissue fluid and allow it to be pumped into the venous system.
Lymphoedema
This is a situation in which overloaded or inefficient lymphatic vessels become obstructed by the excess of the lymph and metabolic wastes contained therein. The accumulation of a high-protein excess of liquids under the skin in the intercellular space causes edema. It manifests itself clinically with swelling of the toes, back of the foot, lower leg or thigh with often accompanying inflammation of the skin. Initially, slight, spontaneously resolving swelling can over time become very large, causing deformation and disability of the leg.
Causes of lymphatic edema:
a) congenital - having a genetic background - manifested by a lack or insufficient education of lymphatic vessels,
b) acquired puberty - caused by rapid growth causing underdevelopment of the lymphatic tract (with the simultaneous participation of bacterial infection of the limb or injury)
c) damage to roads and lymph nodes as a result of fracture, leg dislocation, surgical removal of lymph nodes, radiotherapy, paralysis and paresis of the leg, long-term immobility.
d) closure of lymphatic vessels through tumor pressure, fibrosis, bacterial infections, etc.
The varicose veins cause edema
Stasis of blood in the surface veins increases the hydrostatic pressure in the venous system of the legs, which may lead to widening of venous trunks. As a result of the stretching of the vein wall, increased fluid permeability to the non-vasal space and the formation of edema occurs. These swellings usually disappear after night rest. The areas of blood stagnation and the outbreak of thrombosis appearing near the varicose veins also promote inflammation of the subcutaneous tissue. In the more advanced stage of the disease, the swelling becomes hard, not giving way. It is most often located near the ankles on the back of the foot and even around 1/3 of the lower leg.
Injuries cause disorders of microcirculation and edema
Intensified fluid filtration in the microcirculation occurs after a strong injury. The injury causes local inflammation, which if untreated, effectively sustains the circulating leakage of blood plasma into surrounding tissues. The consequence is the accumulation of fluids and mediators of inflammation under the skin in the intercellular space causing deepening inflammation and swelling.
Paralysis of leg muscles threatens edema and its complications pose a serious threat to health
A particular threat to health is the stagnation of blood in the deep veins due to paralysis of the leg muscles and the swelling caused by it. Such edema is, for example, a disorder of people with spinal cord injury. Such injuries are caused by swelling of the ankles because the leg muscles do not pump blood and lymph from the tissues to the large veins towards the heart. Stasis of blood causes a strong swelling of the legs during the first few months after the injury. If there is a strong swelling of the legs in people with a spinal cord injury during the first month after the injury, it is most often a condition caused by deep vein inflammation. This disease can also cause swelling of the ankle. This is a serious condition, if left untreated, it can lead to thrombosis and pulmonary vein infarction and even death.
ed. Edward Ozga-Michalski, MA
Literature:
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