Blood flow reaches the heart through valves along the veins. Chronic Venous Insufficiency (CVI) is caused by damaged valves in the veins which allows blood to flow backwards and away from the heart. Due to the faulty valves, the excess fluid starts pooling in the tissues of the legs
and feet. Blood flow is reduced and gradually one experiences swelling and pain that worsens over time.
When the lymphatic system fails to drain the excess fluid in tissues, it may result in Lymphedema of the affected areas. Increased tissue fluid in affected areas causes abnormally high protein-rich lymph. Lymphedema may also be due to the damage or removal of lymph nodes due to cancer therapy or radiation, which may lead to the pooling up of fluid in the nodes.
A person with Chronic Venous Insufficiency shares similar symptoms. Leaky valves allow blood to pool in the leg vein and may lead to visible varicose veins on the skin. Swelling and throbbing pain are common in the affected veins.
The circulatory and lymphatic systems always maintain a delicate balance in the body. If the venous system is damaged, it will typically affect the lymphatic system. In several older adults, a condition known as phlebo-lymphedema may occur which is an outcome of the joint failure of
the ‘mutually dependent’ Venous-lymphatic circulation system.
Though symptoms are similar, the causes and treatment for CVI and Lymphedema are quite different. Diagnosing lymphedema is largely dependent upon clinical presentation. Unlike venous disorders which shows clear clinical symptoms, typical characteristics of Lymphedema do not externally manifest until its advanced stages.
Risk factors for CVI and Lymphedema
High blood pressure, excessive weight gain and diabetes can increase your chances of developing CVI and phlebolymphedema.
Differentiating CVI and Lymphedema
- CVI is more common in older people. Studies have shown that more than 20% of patients who suffer from the condition are over 70 years of age.
- Primary Lymphedema, due to defective lymphatics, is noticeable at birth or may occur during childhood, adolescence, or during middle age.
- Secondary Lymphedema due to damage to the lymphatic system may occur any time as a result of injuries, any surgery or cancer treatment.
- Pain associated with CVI usually occurs during or after walking/standing and elevating your legs may reduce the pain.
- Pain associated with Lymphedema may be caused by swelling, joint problems, and increased weight of the limb and elevating your legs may not usually bring much relief
- Swelling due to CVI usually occurs in the lower leg and ankles and is mostly symmetric in both legs.
- Lymphedema swelling may affect the entire limb and foot and may not be symmetric.
- Swelling due to CVI might reduce overnight after sleep.
- Lymphedema related swelling generally do not reduce during the night.
In the absence of Lymphedema, compression stockings for improved blood flow, medicines for skincare treatment, vein stripping, sclerotherapy are beneficial for CVI. For severe cases of Lymphedema, complete decongestive therapy is the recommended treatment.
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