The Cause of Vein Problems

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The Cause of Vein Problems: Failed Valves in Veins
Vein disease is truely one of the simplest problems in medicine! It is mechanical, involving only vessels and valves, with no complicated biochemical issues. Vein disease 'in a nutshell':

Imagine the five major veins that drain the surface of each leg as being upside-down 'trees'. These veins have valves about every six inches. When leg muscles contract, the valves in the 'trunk' of this 'tree' allow blood to flow one way - upward - toward the heart. When the leg muscles relax, these valves act as platforms, preventing backward flow and holding up the weight of the column of blood.

If the valves fail, the 'branches' and 'twigs' below must hold up the weight of a column of blood all the way up to the heart.

With this increased pressure from failed valves, the 'branches' of this upside down 'tree' of veins distend and become painful varicosities both on the surface of the leg (1 of 10) and inside the leg (9 of 10) causing pain, cramping, restless, 'tired' legs.

Also, with this increased pressure, surface capillaries, the 'twigs' of our upside-down 'tree', distend and become spider veins. Increased pressure also causes fluid with protein and blood cells to leak from deeper capillaries, causing swelling and skin changes.

Failed valves in the veins often cause the following conditions: Swollen Ankles, Night Cramps, 'Charley Horses", Red/Brown Discoloration, Painful/Tired/Aching Legs, Ulceration, Scaling, Itching, Burning Skin, Varicose Veins and Spider Veins, Purple Ankles and Instep:

The systems of veins are like upside-down trees. The valves in the 'trunk' act as scaffolds, little platforms that hold up the weight of the column of blood above when you are upright. When these valves fail (genetics, age, standing occupation, pregnancy, injury), all the vessels below are under pressure...holding up the column of blood. The 'branches' of this upside-down tree dilate and become varicose veins inside (9 of 10) the leg and sometimes on the surface of the leg causing aching, tired and painful legs. The 'twigs' of this upside-down tree are the capillaries. These are fragile vessels and they are not designed for this increased venous pressure. On the surface of the leg they can dilate to form spider veins and purple discoloration at the ankles and inside arch of the foot. Inside the leg, these 'twigs', capillaries, leak fluid, protein and blood cells all day while you are upright. This causes swollen ankles (edema), sickened skin (red/brown discoloration, itching, burning, scaling and even ulceration) and, at night as this fluid returns, patients often have cramps/'Charley Horses'). In our office, we fix this condition by gently closing the malfunctioning 'trunk' with laser.....the blood goes naturally through the 'perforators' and other alternate pathways to the deep system, improving its flow and lessening the chance of deep clots, and the surface is relieved of this pressure....varicosities shrink (pain relief) and the capillaries stop leaking fluid (relief of swelling, skin conditions and cramps).

Mountcastle Vein Centers
727-865-6941

Vein Disease Explanation for Patients

Vein Disease:

Vein problems all involve issues of Valves, Pipes and Gravity:
Five systems of veins (greater and small saphenous, anterior and posterior accessory, and the vein of Giacomini) drain the surface of each leg. Each vein system is like an upside-down tree, i.e. each has a main trunk, branches, and twigs. There are one way valves throughout each of these vein systems.

Valves:
When the leg muscles contract, the venous blood is pushed upwards, toward the heart. When the leg muscles relax, the force of gravity causes the venous blood to fall backward, toward the feet. The vein valves prevent the blood from flowing backward, down the leg.

Venous Hypertension:
If the valves in the main trunk have failed, i.e. are ‘incompetent’, the whole vein system below is now under increased pressure, holding up the weight of the column of blood all the way to the heart instead of just to the next valve. The vessels below dilate and, under increased pressure, leak.

Varicosities (Hidden and Visible):
The branches from the trunk dilate under pressure resulting from failed valves above. These branches become varicose veins (dilated and twisting). 90% of varicose veins are inside the leg and not visible from the surface. Patients can have terrible varicose viens and pain, yet have nothing visible on the surface of the legs to indicate a problem. These veins cause aching, tiredness and heaviness; the legs feel ‘older’ than they should and hurt at the end of the day. Varicose veins on the surface can also hurt and are unsightly. Varicose veins are dangerous. Varicose veins increase the risk of superficial phlebitis which is associated with a 400% increase in the incidence of deep vein thrombosis.

Spider and Reticular Veins:
The twigs, small and larger capillaries, under pressure from failed valves above, dilate and become red ‘spider veins’ and wider, purple ‘reticular’ veins. These are not only unsightly, but they also, cumulatively, cause some discomfort. 20% of patients feel significantly better when these are closed with sclerotherapy. The purple reticular veins can bleed rather dramatically under pressure. Many older patients have clusters of these purple veins, especially at the feet and ankles. They often experience frightening bleeding. These veins are easily closed, greatly improving appearance and preventing bleeding episodes.

Night Cramps, Swollen Ankles, ‘Secondary’ Restless Symptoms, and Stasis Dermatitis:
The twigs, the capillaries under pressure, leak. These capillaries, designed to hold the pressure of a column of blood to the next vein valve, are now supporting the pressure of a column of blood all the way up to the heart. Under pressure, these capillaries leak fluid, protein and blood cells. The skin congested and with poor blood flow, becomes 'sickened': reddened, scaly, itching, burning, and eczematous. Ulcerations can result. The accumulated hemoglobin darkens the skin. Fluid leaks from the capillaries causing swollen ankles. Often the need to move the legs to relieve congestion is mistaken for true ‘primary’, brain based, restless leg syndrome. At night, the edema fluid that has accumulated throughout the day returns to the capillaries and the muscle cell membrane balance is altered. This triggers night cramps.

Palm Harbor
(US-19 & Alderman Road)
Serving the cities of:
Dunedin, Palm Harbor,
New Port Richey, Odessa
34918 US-19 N
Palm Harbor, FL 34684

Largo
(at the HCA Largo Medical Center Campus)
Serving the cities of:
Belleair, Seminole,
Clearwater
168 14th St. S.W.
Largo, FL 33770

Largo
(Brian Dairy)
Serving the cities of:
Seminole, Pinellas Park,
Clearwater
7241 Bryan Dairy Road
Largo, FL 33777

St. Petersburg
(Isla del Sol)
Serving the cities of:
St. Pete Beach, Tierra Verde,
Maximo, Gulfport
5901 Sun Boulevard, Suite #113A
St. Petersburg, FL 33715

Sun City Center
(Upper Creek Drive)
Serving the cities of:
Tampa, Wimauma,
Ruskin, Apollo Beach
4040 Upper Creek Drive, Suite #105
Sun City Center, FL 33573

Call (727) 865-6941 in Pinellas County.

Call (813) 634-1333 in Hillsborough County.

Toll free 888-875-6941

Daniel J. Mountcastle, MD, FAAEM, Director
Board Certified
Ohio State University College of Medicine,
Class of 1974
Specialty Practice for Leg Veins,
Member of American College of Phlebology

The Cause of Vein Problems

Mountcastle Vein Centers727-865-6941

Mountcastle Vein Centers
727-865-6941