Do you often experience tired, aching legs, swollen ankles, frequent pins and needles, or night-time calf cramps? These symptoms could point to chronic venous insufficiency (CVI)—a surprisingly common yet underdiagnosed condition that affects around one in 20 people worldwide, especially those over 50.
Donald Trump’s Diagnosis Brings CVI Into Focus
As reported by TOI, CVI recently gained attention when former US President Donald Trump, aged 79, was diagnosed with the condition. His physician described it as “benign” and quite common in older adults. However, Indian doctors warn that awareness about CVI remains low, and many individuals seek medical help only when the condition has progressed significantly.
Understanding CVI: When Veins Malfunction
In a healthy circulatory system, arteries carry oxygen-rich blood from the heart to the body, while veins return deoxygenated blood back to the heart. CVI occurs when valves in the leg veins fail, causing blood to flow backward and pool in the lower limbs.
“When leg veins malfunction, as in Trump’s case, blood accumulates in the legs, leading to swelling,” explains Dr Abhishek Bansal, senior consultant and chief of interventional radiology at Aakash Healthcare, Delhi. This pooling may cause varicose veins, skin discolouration, and even ulcers if left untreated.
Who’s at Risk?
While older adults are more prone to CVI, other risk factors include:
- Sedentary lifestyles
- Long hours of standing
- Smoking
- Recent spinal surgeries
- Pregnancy
“Unfortunately, many patients receive a diagnosis only after the disease has progressed. Even general physicians often lack the training to identify or manage CVI,” says Dr Bansal, who treats several cases weekly.
Not Life-Threatening, But Not Harmless Either
Dr Sushant Srivastava, senior consultant in cardio-thoracic and vascular surgery at Indraprastha Hospital, sees four to five CVI cases each month. He notes, “Symptoms are usually mild at first—skin discolouration or mild swelling. Because they’re not acute, most people ignore them.”
However, if untreated, CVI can lead to serious complications, including deep vein thrombosis (DVT)—a blood clot in the deep veins. In rare cases, the clot can travel to the lungs and cause pulmonary embolism, a life-threatening emergency.
CVI Often Discovered by Accident
Dr Tarun Suri, head of orthopaedics and ortho-spine surgery at Amrita Hospital, Faridabad, often encounters CVI during unrelated consultations. “Many patients come in for back or joint pain, but clinical evaluation reveals a vascular issue, not a musculoskeletal one,” he explains.
Since vascular conditions can mimic age-related fatigue or joint discomfort, orthopaedic and vascular specialists must collaborate to ensure accurate diagnosis.
Recognising Early Symptoms
Early signs of CVI include:
- Swelling in the lower limbs
- Darkened skin around the ankles
- Persistent heaviness or discomfort in the legs
What Can Help: Lifestyle Changes and Medical Interventions
According to Dr Rajesh Malhotra, senior orthopaedic surgeon at Apollo Hospital, simple lifestyle adjustments can greatly ease symptoms. He recommends:
- Wearing compression stockings
- Doing calf raises
- Elevating the feet regularly
For advanced cases, non-surgical or surgical procedures like vein ligation may be necessary. Dr Srivastava stresses the importance of staying active, avoiding prolonged standing, and maintaining a healthy weight to manage or prevent CVI.