From the Veins to the Heart: A Rare Cause of Varicose Veins

Abstract

The presence of pulsating varicous veins is an uncommon finding, generically attributed to right heart failure. The precise causes of this phenomenon have been poorly defined in the literature. The finding of this infrequent condition is important because it may be a sign of major diseases, often not known. Here we described a 75-year-old woman presented to the Angiology Unit for the presence of bilateral pulsatile swelling in her groin and along both lower limbs. A bedside ultrasound examination showed an arterial like pulsating flow both in the superficial and in the deep veins of the lower limbs due to a severe tricuspid regurgitation not previously known.

Doppler Interrogation of the Femoral Vein in the Critically Ill Patient: The Fastest Potential Acoustic Window to Diagnose Right Ventricular Dysfunction?

“…The correlation between abnormal CFV spectral Doppler profiles, hepatic venous flow ( 32 ), Y descent ( 42 ), elevated right atrial pressure ( 27 ), and RV dysfunction ( 33 ) has been reported ( 26 – 31 , 33 , 43 ) but not in a simultaneous manner as demonstrated in our cases.…”

Association of spectral Doppler cardiac activity in the lower limb veins and echocardiographic findings in patients with tricuspid regurgitation

“…However, researchers disagree on the nature of phasicity of venous Doppler waveforms. Some think this phasicity is cardiac in origin, reflecting changes in right atrium pressure; others argue that the changes are respiratory; a third group describes the phasicity as sometimes respiratory and sometimes cardiac ( 30 ) . The disagreement reflects a lack of understanding, which leads to a lack of interest, and consequently a scarcity of reports addressing the significance of the pulsatile flow in these waveforms ( 31 ) .…”

A leg ulcer with pulsating varicose veins – from the legs to the heart

“…Pulsating varicose veins have been rarely reported in the literature . The most common misdiagnosis of arteriovenous malformation can lead to unnecessary surgical exploration without considering the diagnosis of severe heart failure.…”

“…In most cases, the vein varicosis is primary; it is secondary only in 5–20% due to conditions such as deep vein thrombosis, pelvic tumours or arteriovenous fistulas . The presence of pulsating varicose veins is an uncommon finding, which is rarely reported in the literature and has been attributed to right heart failure .…”