Circulatory and Microcirculatory Failure

Circulatory failure

Venous insufficiency is a disorder of circulation, characterized by a difficult return of blood from the extremities to the heart and is manifested in most cases with the appearance of embossed capillaries, telangiectasias or varicose veins that became enlarged, dilated and tortuous evident on the surface of the skin in other parts of the body level.

The decreased ability of the veins to return blood to the heart can be caused by a loss of elasticity and tone of the venous vessels or poor functioning of the valves positioned inside them, essential to counteract the force of gravity that is opposed to the ascent of the blood flow from the feet to the heart. In practice the passage of blood, if the valves are defective and do not close perfectly, are not able to prevent the blood to return down when you are in the upright position, instead of being pushed towards the heart. Thus the blood tends to stagnate and to weaken the walls and the tone of the veins with a further deterioration of valve operation. This results in a feeling of heaviness, swelling and inflammation in the ankles and legs and sometimes ulcers especially in the area around the ankle.

Risk factors, signs and symptoms

There are numerous risk factors cause of venous insufficiency including overweight and obesity, age, pregnancy, familiarity, water retention, the use of hormonal contraceptives, physical inactivity, nutrition, genetic predisposition and the type of work (long hours standing and real estate). Women also are more predisposed than men because of hormonal changes (estrogen and progesterone).
Other conditions that obstruct the physiological venous return to the heart, and to promote the formation of thrombi, are immobility in bed, the cast of a leg and surgery of the lower limbs.
The classic sign is the appearance of bluish and soft vessels under the skin, especially of the legs, due to the stagnation of blood.
The most common symptoms are swelling (edema) in the feet and ankles, heaviness and heat in the legs, tingling, cramps, itching and pain, especially at night.
The disorders tend to worsen during the day, when you are going for a long time standing and on hot days.
The enlargement of the veins can also affect other parts of the body, for example the anal plexus, with the formation of hemorrhoids.
Venous insufficiency can determine the rupture of the fragile vessels with the appearance of blue spots on the more or less expanded, skin varicose veins, hemorrhoids, and phlebitis.
In severe cases can develop deep vein thrombosis, very dangerous.

Care and Treatment

In the presence of risk factors that predispose to severe venous insufficiency (obesity, pregnancy, immobility), swelling and pain spread to the ankles and legs, cramps, ulcers or a previous episode DVT is necessary to contact the Angiologist specialist.
Usually it is first useful to perform a Doppler ultrasound of a (similar to a painless ultrasound examination) which allows you to see in great detail the conditions of the veins of the lower limbs.
To improve blood circulation and prevent complications it is important to correct any risk factors related to lifestyle, such as physical inactivity and overweight, for example by walking as much as possible, keeping your legs raised, often getting up on his toes and abolishing the smoke of cigarette. Especially people with hereditary predisposition venous insufficiency and pregnant women should routinely wear elastic stockings with gradual compression, prescribed by specialist Angiologist that are very effective in reducing swelling and heaviness in the legs, or elastic bandages (performed by an expert) to prevent the veins to dilate.
Sometimes the specialist may be associated with these measures of medicines which help to reduce noise caused by insufficient venous or improve circulation.
Thanks to the fact herbal medicine can prevent circulatory disorders and preserve the health of the lower limbs. The use of drugs and supplements it with vasoprotective action is useful to strengthen the elasticity of blood vessels and reduce swelling in the legs.
Among the medicinal plants that perform this activity they are widely used Asiatic centella, red vine, blueberry, horse chestnut and ginkgo biloba.
In some cases, in the presence of varicose veins or telangiectasias it may be necessary to resort to sclerosing therapy (injection of substances in the veins which cause the closure) or minimally invasive outpatient therapy with Laser (EVLT) which in many cases can replace the extraction surgery the vein.
It should also be noted the negative effect of excess heat in the limbs. So they are advised very hot baths and sun exposure during the hottest hours of the day. It is also important to avoid injuries and leg injuries and cure the hygiene of the skin by washing with neutral detergent and drying it thoroughly. If the latter were nonetheless to become dry, thin or cracked should apply an emollient cream at night after bathing or showering. It is crucial finally to evaluate as soon as possible to the doctor any wound, however small, that appear on the skin of the legs and feet.

RSS Journal of Vascular Surgery