Varicose Veins: Pathophysiology, Presentation, and Complications

Varicose veins are dilated, tortuous superficial veins, most commonly in the lower extremities. They result from:

• Venous valve incompetence → reflux
• Weak venous wall (genetic, hormonal)
• Increased hydrostatic pressure (prolonged standing, obesity, pregnancy)

Clinical Features

• Visible, bulging blue veins
• Aching, heaviness, itching, edema
• Skin changes: stasis dermatitis, lipodermatosclerosis, ulceration

Complications

Superficial thrombophlebitis, bleeding, venous ulcers, DVT (rare).

Treatment ranges from compression therapy to endovenous ablation, sclerotherapy, or surgery.