What examinations need to be done to check for varicose veins. Diagnostics of varicose veins: modern approach and techniques

Varicose veins, or varicose veins, is an extremely unpleasant disease, unfortunately, very common, especially among women, who suffer from it 3 times more often than men. The problem is that we often do not rush to the doctors when the first symptoms appear, writing off the heaviness in the legs and swelling for ordinary fatigue.

However, varicose veins, like many other diseases, are insidious in that it is easy to cure it just in the early stages, and even surgical intervention may be required at an advanced stage. That is why it is very important to know how varicose veins begin in order to start on time and prevent the development of complications.

As a rule, in the early stages the symptoms of the disease are mild, so they are easy to miss. Patients attribute the increased fatigue of the legs to long-term walking or standing. Uncomfortable shoes, cramps are considered a manifestation of a lack of essential minerals in the body - calcium, magnesium.

And only the appearance of pronounced spider veins and varicose veins makes one think about varicose veins. In fact, when the above symptoms appear, it is better to consult a doctor so that he confirms or refutes the presence of the disease, and, if necessary, begins a timely, which means effective treatment.

If you do not pay attention to the initial edema, which first pass on its own in the morning, enlarged veins and the appearance of asterisks, you can face symptoms of later stages, much more unpleasant: the appearance of dermatitis, and so on. Then complications develop, such as thrombophlebitis, deep vein thrombosis, trophic ulcers, etc.

How to distinguish varicose veins from common veins and other diseases

Varicose veins were previously considered a disease exclusively for retirees. Nowadays, many fairly young people have symptoms of this disease. Varicose veins are blockages and thinning of the vascular walls, leading to swelling and nodules.

As with any disease, varicose veins are much easier to cure at the initial stage. To do this, you need to understand its symptoms and distinguish real varicose veins from ordinary cosmetic defects. Everyone should know how varicose veins on the legs begin. An example of how varicose veins begins in the photo above.

This disease at the very beginning is almost never manifested. In addition to swelling, and even then a little, and fatigue, absolutely no changes are visible. But the appearance of small swellings along the vein is already a reason to think.

Symptoms of varicose veins

How does varicose veins begin?

To know how to identify varicose veins, we list its main symptoms:

1. The pain, can be both when walking and at rest, is often acute.
2. Convulsions at night.
3. Edema appears, usually in the evening. At the same time, the shoes, which could be freely put on in the morning, press on in the evening.
4. Feeling of heaviness in the legs.
5. Increased fatigue.
6. Skin changes. First, dryness appears, then pigmentation - the skin darkens, brown spots appear on it, in advanced cases dermatitis and eczema occur.
7. Enlarged veins. They become convoluted, protrude on the surface of the skin of the feet and legs, and have pronounced extensions.
8. The appearance of spider veins.

The appearance of an individual does not necessarily indicate the presence of varicose veins, but clearly indicates that it is worth contacting a specialist. For example, heaviness in the legs and high fatigue may indicate osteochondrosis or flat feet.

In fact, symptoms progress over time, so experts distinguish several stages of the disease:

• the first - passing without painful sensations at all, only the first cosmetic changes appear;
• the second is accompanied by the appearance of a feeling of stretching of the legs and heaviness, cramps at night;
• third - when there are noticeable swelling, skin tightening;
• the fourth is the stage of ulceration.

It turns out that the main method for determining varicose veins of the legs is to closely monitor the state of the vessels. Indeed, most often women, when they first find dilated veins, get upset, but do not rush to the doctor, deciding for themselves that this is age sign and all people have it. They are sent to a phlebologist only after the onset of discomfort, that is, at least at the third stage of the disease.

Vascular changes are best seen with thin and pale skin, then even the thinnest trunks of veins under the skin or a network of bluish vessels are visible. Then, pronounced varicose nodes begin to appear, usually on the inner surface of the thighs or lower legs.

To diagnose early stage, you need a consultation with a surgeon, a neurologist and a phlebologist directly, and from diagnostic methods you will definitely need an ultrasound examination or phlebography.

Do not postpone a visit to your doctor, especially if you have a hereditary predisposition to this disease. Then you will stop the process in time, which not only causes a lot of unpleasant sensations, but also worsens appearance beautiful female legs... My patients have used, thanks to which you can get rid of varicose veins in 2 weeks without much effort.

How to prevent the disease?

Of the preventive measures, when the first signs of varicose veins appear, means are offered to prevent the progress of the disease and its exacerbation. Prevention of varicose veins is, first of all, correct and healthy eating, drinking a lot of water, as well as vegetables and fruits that prevent blood thickening.

If varicose veins begin, what to do?

1. Test your shoes. A comfortable heel and a comfortable shoe last can prevent beginning varicose veins (see photo).
2. Compression underwear - stockings, tights, knee-highs. For warning further development disease, at the first signs of its appearance, it is necessary to use special golfs or stockings, which will prevent further bursting of the veins.
3. Complete cessation of harmful smoking. Smoking leads to narrowing of the walls of blood vessels and their sticking, which inevitably leads to the formation of venous obstruction. Therefore, at the slightest sign of varicose veins, you should end this habit.
4. Massage light procedures. It is light stroking and self-massage that help to increase the elasticity of blood vessels and improve blood circulation, which prevents the formation of nodules and bumps. Deep massage on the area of \u200b\u200bnodules is not recommended.

At the present time, the overwhelming majority of people are sure that a varicose defect is a cosmetic problem. It is this, initially incorrect, judgment about this disease that leads to the fact that people develop dangerous complications.

Vein diagnostics should be mandatory if swelling appears on the legs. It is important to understand that ignoring such a problem inevitably leads to a deterioration in human health.

Diagnosis of varicose veins is carried out by different modern techniques, which are absolutely safe and have no contraindications. Due to the fact that modern medicine does not stand still, not only diagnostics, but also treatment can be carried out completely painlessly. But only when the person asked for help in a timely manner.

If vascular patterns appear, this is the first signal that the human venous system has big problems. So, the places where such peculiar patterns were deployed will be subject to varicose veins in the future.

And in order to protect yourself from such a nuisance, you need to visit a specialist. A visit to the doctor is required, even if the person is sure that he is not in danger. Only when full examination it will be possible to find out if there is a risk to a person.

At the moment, there are countless different methods, with the help of which the diagnosis of varicose veins in the legs is carried out in a matter of minutes and is completely painless.

So, what diagnostic methods are available to a person:

• visiting a phlebologist doctor specializing in venous problems;
• examination using tests to establish the degree of damage;
• scanning of veins;
• dopplerography;

All of the above methods are the most popular at the moment and the safest. Carrying out diagnostics using one of the techniques, a person will not feel any discomfort.

And you can completely forget about painful sensations, since such devices are the most gentle in the world. Moreover, these techniques have no contraindications for use. Therefore, they can be used for people of different ages.

We pay a visit to a phlebologist

For any medical problem, you should always consult your therapist. But at the same time, if a person independently navigates which doctor to contact when a specific problem is identified, this will help save a lot of time.

So, if you have problems with the lower extremities, you should visit a phlebologist, if this specialist is not in medical institutionthen a vascular surgeon would be an alternative.

These specialists will accurately determine whether such a defect is cosmetic or if it is urgently necessary to carry out medical therapy. It is important to understand that there is no time to waste when diagnosing a varicose defect.

As for the phlebologist, it is important to know that these specialists are qualified in several areas at once, namely:

• dermatology;
• general surgery;
• vascular surgery.

Also, the specialization of these doctors may differ depending on the country in which this doctor practices.

How is the diagnostic examination that is necessary for an accurate diagnosis carried out? First of all, the phlebologist studies the patient's history and performs a visual examination, followed by a questioning of the person for his complaints.

Vein scanning method

After a preliminary picture of the course of the disease has been established, the specialist makes an appointment for a vein scan.

Today it is the most common technique, thanks to which the diagnosis of varicose veins of the lower extremities is carried out successfully. And most importantly, this is a complete absence pain during such a session, and all the risks in relation to radiation are reduced to zero.

Thanks to such an examination, all defective areas will be visualized, due to which it is possible to accurately determine the degree of damage. Also, this technique is very necessary in order to draw up a specific treatment plan.

As for the time required for this manipulation, depending on the degree of the lesion, the diagnosis can take from 5 to 20 minutes.

Good old ultrasound

Ultrasound examination. Such a diagnosis is indispensable, since the doctor has the opportunity to examine in detail every part of the human body using safe sound waves.

The ultrasound technique is performed as follows: a gel that transmits contact is applied to a specific area, then a doctor guides a special probe over the affected area and, using a sound wave, a complete picture of what is happening with the veins is displayed on the monitor.

Diagnosis of varicose veins using ultrasound is one of the most effective methods today. The fact is that ultrasound is the safest and most accurate way to identify the degree of venous damage.

Doppler ultrasonography

Another equally effective diagnosis is Doppler ultrasound. This technique is used to measure the flow of biological fluid in the heart and vascular system.

And such manipulation is performed as follows: sound waves sent by the apparatus hit the cells of the biological fluid and in the vessels. And on the basis of the received data on the frequency change, this ailment is revealed. Such changes are displayed on the screen of the device as a curved line.

If a person has a suspicion of varicose veins, the diagnosis must be carried out urgently.

Duplex ultrasound

Varicose veins of the lower extremities can also be determined using duplex scanning of the venous system. What is duplex ultrasound? This is a tandem of black and white imaging and a system for measuring the running of body fluid. It is worth emphasizing that this particular technique is the most modern at the moment.

This type of ultrasound helps not only diagnose the disease, but also monitor how the defect develops. Moreover, with this device it is possible to fully examine the deep veins, all arteries, material and superficial veins.

In addition to the above-described effect, this technique allows tracking the direction of the biological fluid of the vessels of the lower extremities. This information is very useful as the attending physician can trace the presence of blood clots and all the so-called valve breakages.

What other additional methods are there for diagnosing a venous defect?

First of all, the methods for diagnosing such a disease described below are used as an additional measure for establishing a diagnosis. The overwhelming majority use these methods so that the attending physician can determine the pressure in the biological fluid and how well the muscle pump is doing its job.

In addition to the above, these techniques also help to determine how effective the previously performed procedures were to eliminate this defect. So, with regard to these manipulations, it is worth emphasizing that they are completely painless and do not require anesthesia.

Photoplethysmography

This technique is known as reflective rheography. For this manipulation, infrared light is used to determine the functioning of the venous system.

And such a procedure takes place as follows: a sensor with a beam is fixed on the patient's skin, preferably on the inner side of the leg. And then the doctor proceeds to the manipulation.

As for the amount of light that is directed to the affected area, it all depends on how much the veins are damaged by varicose veins.

In order to carry out this manipulation, a person must sit down and lower his toes ten times. It is necessary to perform such an exercise with fingers, since before carrying out this manipulation, the muscle pump should be activated.

It is worth noting that doing the finger exercise can temporarily cleanse the veins. If the natural fuses are damaged and they do not close, as necessary, then the biological fluid makes a wrong run, while replenishing the veins much faster than in a person who does not suffer from such a defect.

It is important to understand that the fast running of the biological fluid indicates that the defect is rather difficult.

Venous occlusive plethysmography

This method is used by specialists in the case when it is necessary to measure the volume of biological fluid, if there is a suspicion of varicose veins in the legs.

This technique is performed as follows: a special sensor is fixed on the human lower leg, which measures all changes related to the biological fluid, and a little higher, a kind of cuff is fixed, which is used to regulate the flow of biological fluid.

To perform this procedure, a person needs to lie on a table and raise their legs up. In this position, you should spend about 3 minutes and only then begin to perform the manipulation.

The fixed cuff is inflated to measure the pressure of the body fluid. The inflated cuff enlarges and temporarily blocks the flow of blood. Accordingly, the biological fluid stops flowing into the heart through the veins, but continues to flow into the arteries. And in this position, the specialist fixes all the necessary indicators.

If the veins are completely healthy, then their filling is fully consistent with the norm. In the event that there is a lesion of the vessels of the lower extremities, there can be no question of the norm.

After all the necessary measurements have been made, the cuff is removed and the flow of biological fluid resumes.

Diagnostic method: phlebography

To date, such a technique as phlebography is used in very rare cases. As a rule, it can be prescribed only if other methods are contraindicated for a person for any reason.

Phlebography is a procedure that involves the use of injections. To carry out such a procedure, a substance is injected directly into the vein, which contains iodine. Such a measure is necessary so that X-rays with a clear picture of the affected veins are obtained at the exit.

It is worth emphasizing that in most cases, varicose veins of the lower extremities are primary disease... In other words, such a defect appeared due to weak connective matter.

But the secondary appearance of such a defect can occur due to another disease, for example, such as thrombosis. It is for this reason that it is very important to promptly seek help from a qualified specialist.

Conclusion

Thanks to modern medicine, the diagnosis and treatment of such a defect is an absolutely painless procedure. Therefore, you should not be afraid or ignore the symptoms of this defect.

It is important to understand that varicose veins are very dangerous precisely because of their possible consequences in the form of blood clots or thrombophlebitis. Moreover, such a defect should be feared due to the appearance of trophic ulcers, which are very difficult to treat.

Treatment of varicose veins can be painfully long or relatively short, it all depends only on the person and his desire to be healthy.

I was going to the phlebologist for a long time, but slowly. The suspicion was caused by a small vascular network, indicated on the inner side of the lower leg. I heard from the beautician about this: "We can easily remove it with a laser." But before starting the procedure, I wondered what the phlebologist would say about this. Just for comparison.

First, as usual, you had to fill out a questionnaire, indicating a fair amount of information about yourself. This included: information on medications taken, including hormonal contraceptives, fractures, flat feet, pregnancy (former, planned or current), age, weight, and bad habits. In conclusion, it was necessary to indicate the subject of concern. At the moment, I was not worried about pain and swelling, but I was only worried about the aesthetic side of the issue.

I knew little about how phlebological research is carried out. Specifically, that any patient can get a study of the patency of the veins. I did not have information about how long, painful (and maybe even bloody) this procedure was.

The beginning of the examination turned out to be cheerful: without pants, standing on the couch, I have to show my legs for a visual examination. Then we proceeded to Doppler ultrasonography - the very study of vein patency. In practice, it turned out to be very similar to an ultrasound scan: you lie on your back, sometimes at the command of the doctor you hold your breath, and as a soundtrack you hear the sound of your own blood in the speakers. This whole procedure allows you to measure the speed of blood flowing through the veins, to assess the condition of the valves of large veins.

First conclusion: the study of vascular patency took about 10 minutes and turned out to be fearless and painless.

While I was lying and not without pleasure digesting the phrase: “The valve on the right leg is working perfectly”, it turned out that we were going to have the second part of the examination: transillumination, that is, shining through the leg with a special lamp. It looks very unorthodox: the light is turned off in the office, and nothing else distracts us from contemplating the leg area illuminated by a reddish light beam. In this light spot, problematic vessels are perfectly visible. It turned out that not everything was so smooth with me. If the right leg could even be sent to the Olympic Games, then the left was less fortunate: varicose veins at the initial stage. And most importantly, the problems were found completely in the wrong place where the notorious vascular network loomed, prompting me to visit a phlebologist.

Second conclusion: not all problems with blood vessels are visible to the naked eye.

Alas, on the agenda there was a question: “Did I really get to varicose veins?”, Smoothly flowing into another: “What to do now?”. We took up the discussion of these pressing problems with Dr. Igor Alexandrovich Tsarenko.

Probably everyone who is on the verge of a disease expects to buy off it with prevention or radical changes in lifestyle. For example, at the first signs of gastritis, you can quickly switch to oatmeal, and you can buy off bronchitis by quitting smoking.

With varicose veins, everything is fundamentally different. If I were a fan of Zen, I would say that varicose veins are the way. Simply put, if the disease has begun, then no preventive measures, no diet, sports, the use of venotonics can block it. Varicose veins will develop. According to statistics, one in four is 11 years old enough to go from the onset of the disease to disability - provided that he does not lift a finger to treat varicose veins. Moreover, it is not so much varicose veins that are terrible as its complications: thrombophlebitis, deep vein thrombosis, bleeding from varicose veins and the most irreparable blockage pulmonary artery a detached blood clot.

The third conclusion: if you do not deal with varicose veins in the early stages, the situation will only get worse. Required.

In a word, the presence of varicose veins, even at an early stage, leaves no room for maneuver. And from that moment, patients begin throwing themselves, trying to come to terms with the idea that they are threatened in their prime surgery... Not everyone knows that there are non-surgical methods to get rid of varicose veins.

For example, such as sclerotherapy, which allows using special injections to "glue" and thereby remove the affected veins from the game. This procedure, according to Igor Aleksandrovich, can be performed even at lunchtime. The only circumstance that complicates life: after a course of sclerotherapy, you will have to wear compression underwear for three weeks.

Another thing is varicose veins in an advanced form, requiring surgical intervention... But even in this case, an operation is possible that allows you to remove the vein through a very small incision.

Some are lucky, others are not very lucky. The main reason for the appearance of varicose veins is a hereditary factor. But something depends on ourselves: we can bring varicose veins closer by our own efforts. To do this, it is enough to perform a few simple steps:

• If you are an office worker, flop into a chair in the morning and do not get out of it until the evening.
• Always sit cross-legged.
• If you have a "standing" profession, you should stand rooted to the spot at work, without shifting from foot to foot, without rolling from heel to toe.
• Visit baths or saunas as often as possible.
• Smoke a lot.

Now, seriously. It is quite difficult to lead a lifestyle that would meet all preventive requirements: only standing can be worse than sedentary work. The banal use of hormonal contraceptives can have a negative effect on the veins. Excess weight does not lead to anything good. And yet: a single phlebological examination will either reveal the problem at an early stage, or provide peace of mind and confidence that you are lucky with the vessels.

Alexandra Izotova

Varicose veins - insidious disease, the first symptoms of which the patient may not notice or attribute to current circumstances. It is imperative not to miss it initial stage... Diagnosis of the condition of the veins, carried out at the right time, reduces the risk of blood clots, prevents the occurrence of venous ulcers, and prevents.

The severity of the disease is not always proportionally related to the visual manifestations, therefore, the stage of varicose veins and the tactics of treatment will be determined after the diagnostic procedures.

Attention! By compulsory medical insurance policy (compulsory health insurance) in the clinic you can go free ultrasound diagnostics veins of the lower extremities and consult a phlebologist.

Survey plan

Each human body is individual, and this is where the difficulties of diagnosing varicose veins lie. The same manifestations in one person may be the norm, and in another - a symptom of the disease. Diagnostics of the condition of veins is a set of measures that includes several stages:

• consultation with a phlebologist;
• delivery of analyzes and functional tests;
• computer diagnostics of blood vessels.

For an accurate diagnosis, you must go through all the stages to the end.

Examination by a phlebologist

Symptoms that indicate the need to visit a doctor:

• Leg pain while walking or playing sports.
• Blood pressure is high for any reason.
• A history of varicose veins, thrombosis, diabetes mellitus.
• , swelling and heaviness in the legs.
• If your feet are cold even with normal temperature environment.

An appointment with a phlebologist begins with an oral conversation. The doctor will ask you to tell about the complaints, specify the date of the onset of the first symptoms of the disease, and take an anamnesis.

Next, a visual inspection is carried out both horizontally and in upright position... The doctor will examine and palpate the legs, groin, pelvis, and abdomen. Attention is drawn to swelling, bulging of the saphenous veins, to color skin... After that, the doctor issues directions for ultrasound examinations and analyzes.

Functional tests

Special tests are used to determine the patency of the veins and the condition of the venous valves.

The condition of the valves of the superficial veins is determined by:

• Troyanov-Trendelenburg test... The patient is asked to take a horizontal position and raise his legs up. On upper part a rubber band is applied to the thighs, after which the patient stands up. If blood quickly fills the veins, this indicates a valve problem.
• Hackenbruch test (test of a cough push). The doctor puts his fingers at the junction of the femoral vein with the great saphenous vein and asks the patient to cough. If the valves fail, the fingers will feel a jolt.

The state of the valves of the communicating veins is determined by:

• Three-core test (Sheinis)... The patient lies down on the couch and lifts lower part torso at 45 degrees, the doctor puts 3 tourniquets on his legs. One under knee jointthe rest are on the upper and middle thighs. Then the patient is asked to get up and walk. Rapid filling of the veins indicates a problem with the valves.
• Pratt-2 test... The patient takes a horizontal position, the doctor rewinds the leg with a rubber bandage in the direction from the foot to the thigh, a tourniquet is applied under the groin. The patient gets up and begins to apply another rubber bandage under the tourniquet. The lower bandage is gradually removed, and the upper one is wound so that a gap of 5-6 centimeters remains between the turns. The doctor controls the filling of the veins in the areas free from bandages: the pathology is indicated by the rapid filling of the vessels.
• Talman test - modified three-wire sample. The difference is that 1 tourniquet is used instead of 3, which is applied from the foot to the thigh with a distance between the turns of 5-6 centimeters.

Deep vein patency is determined by:

• Delbe-Perthes march test... The patient stands, a tourniquet is applied to his legs, squeezing only the superficial vessels. The patient walks for 5-10 minutes. The condition of the deep veins is judged by the distribution of blood: if it goes from the saphenous veins to the deep ones, it is believed that the patency of the latter is normal.
• Pratt-1 test... Markers are made on the calf muscle, along which the circumference of the lower leg is measured. Then, in the prone position, an elastic bandage is wound on the raised leg, after which the patient walks for 10-15 minutes. Problems with deep veins show an increase in the diameter of the lower leg and the occurrence of pain in the leg.

The functionality of the valves of the venous system determines valsalva test... The patient lies down and exhales air for 15 seconds into a special tube connected to the manometer. The test helps to determine the increase in the diameter of the veins and the presence of reflux.

Modern medicine has made a step forward in the computerized diagnosis of vascular diseases. With the help of ultrasound, you can monitor the state of the veins in real time, see the picture of blood circulation on the monitor. Without ultrasound, it is impossible to establish an accurate primary diagnosis and select a successful treatment strategy.

Examinations with ultrasound machines follow the same principle: for better contact of the sensor with the patient's skin, a conductive gel is applied to the legs. Status information vascular system transferred to the computer and displayed on the monitor. You can carry out ultrasound diagnostics in a polyclinic without hospitalization.

Doppler (ultrasound, ultrasound of blood vessels)

One of the most common ways to diagnose vein disease today. With the help of an ultrasound wave and a special apparatus (Doppler), a two-dimensional picture of the movement of blood through the veins is observed.

Allows you to quickly assess the patency of veins (superficial and deep), the work of the venous valves, the blood circulation rate. Doppler ultrasound simple, harmless, relatively inexpensive procedure with high diagnostic accuracy.

Duplex (UZDS, CDS)

(USDS) is considered the "gold" standard for the diagnosis of varicose veins of the lower extremities. Ultrasonography combines 2 technologies - Doppler ultrasound and real-time vein scanning.

Duplex scanning makes it possible to analyze the efficiency of blood vessels, to see areas of narrowing (expansion) of veins, to determine the presence of atherosclerotic plaques and blood clots.

Triplex (CDK)

With triplex scanning, the machine operates in 3 modes. A color doppler is connected to the traditional and duplex modes.

With the help of the CDC, it is possible to simulate a three-dimensional picture of the state of the veins in color mode (patency, the presence of narrowing and dilation, the presence of blood clots), the structure of the vessel walls, the blood flow velocity, and an anomaly in the development of veins. Even with mild symptoms, this method determines pathologies in the early stages.

Phlebography (angiography)

In some cases, ultrasound diagnostics is not able to give an exhaustive answer, therefore it is used x-ray method - angiography. This is an invasive technique in which a contrast agent is injected through a catheter into a vessel, and then monitored on an X-ray machine.

Angiography is divided into 3 types: arteriography for the study of arteries, phlebography - for veins and lymphography - for the vessels of the lymphatic bed. The research process and preparation for it in all cases is the same. The difference lies in the puncture site and the injected contrast.

Phlebography allows you to diagnose, determines abnormalities in the development of blood vessels. It is not used as a screening test for a number of reasons:

The patient should be prepared for the X-ray examination.

• 4 hours before the procedure, refuse to eat, drink only water.
• Before the study, pass tests to determine the degree of blood clotting and allergy to iodine.

After the introduction of contrast and during the procedure, the patient may experience discomfort. There is a possibility of occurrence side effects from input contrast agent: nausea, itching, shortness of breath.

In order to timely identify and cure varicose veins, you will need qualified diagnostics varicose veins. Thanks to achievements modern medicine It is not difficult to determine the process of damage to veins and capillaries, the main thing is not to delay the diagnosis and immediately contact a phlebologist for help.

Methods for examining a patient with varicose veins

The defeat of the veins can appear long before the appearance of visible clinical picture... Increased loads on the legs, unhealthy diet, bad habits, and a sedentary lifestyle contribute to the activation of varicose veins.

Diagnosis of varicose veins of the lower extremities begins with the first stage - examination of the damaged areas by a phlebologist. Through palpation, painful foci, vascular density, vein tension, the presence of edema, and inflammatory processes are determined.

Attention!

The procedure is performed in an upright position of the body so that the veins are filled with blood as much as possible. It is advisable to carry out this procedure in the evening in order to effectively examine the veins after a daytime load.

The first part of the diagnosis of varicose veins in the legs includes a detailed survey of the patient (social activity, presence physical activity at work, at home, allergic reactions, taking medications).

The main components of the anamnesis:

• Genetics;
• Neuralgic and orthopedic disorders;
• Taking hormonal drugs;
• Limb injury;
• Pregnancy;
• Operational interventions;
• Bad habits.
• Composition and diet.
• Physical activity.

After questioning and palpation, the doctor receives primary information about the health of the lower extremities, then the next stage is performed - ultrasound procedure veins.

This method allows you to display the state of veins and blood vessels from the inside, to study information about deformations and impaired blood flow. The specialist acts sound waves on various parts of the body, receiving an image internal organs... The study lasts no more than 30 minutes.

Also, a diagnostic method such as Doppler sonography is used - the condition of the valves of the veins is determined and the internal structure of the blood vessel is assessed.

The equally popular duplex scanning is one of the modern methods diagnosing varicose veins. The procedure allows not only to determine the disease, but also to track its course.

Phlebography is used to display the throughput of the superficial and deep venous system; it is performed on an outpatient basis and does not require hospitalization; it has high reliability and reliability of results.

Before passing this study, it is necessary to pass tests to determine general condition... A week before the diagnosis, you will have to give up alcohol, do not take medications that thin the blood and dilate blood vessels.

Attention!

Paid services for the diagnosis of varicose veins are offered by such private clinics as the Regional Phlebological Center in the city of Tula and the Moscow Region. (Ultrasound from 1600 rubles), Moscow Center of Phlebology (duplex examination from 1500 rubles), "Kredeexperto" Moscow (diagnosis of varicose veins on the legs from 2500 rubles).

Free diagnostics of varicose veins is carried out in some clinics in Moscow (No. 129, No. 134, No. 180), city hospital No. 20 and No. 48 in St. Petersburg, hospital No. 1 in the Saratov region, Engels.

Analyzes for varicose veins

Diagnosis of superficial and internal lesions of veins and blood vessels is carried out using a detailed blood test:

• General;
• Hormone;
• For hemoglobin;
• The presence of an infection.

The second type of diagnostic material is urine (determination for sugar, hemoglobin, acetone, bilirubin, ammonia). Some types of surface analysis are in demand:

• Three-cord test - the patient is placed on his back, the leg is lifted, then, with the help of three tourniquets, veins are squeezed in the groin area, under the knee and in a part of the thigh. If, with a sharp rise, the veins swell, varicose insufficiency is fixed;
• Pratt test - such a diagnosis of varicose veins is used to detect damaged valves blood vessels... During the procedure, the lower limb is fixed with an elastic bandage, the groin vein is clamped with a tourniquet, the patient rises, and the bandage is gradually removed. With the help of analysis, you can determine the degree of development of the disease;
• Talman's test - the patient is laid in a horizontal position for several minutes so that the load leaves the veins, after the doctor pulls the leg with a tourniquet in a spiral, from the bottom up, the distance between the turns is about 6 cm.After that, the legs are examined if the veins are swollen in any area, it means that a place with weak valves was found.

Functional tests can tolerate errors, and therefore, along with them, are used instrumental methods (scanning, dopplerography, x-ray, clearance, etc.).

All information collected using the above methods is analyzed, a diagnosis is made, and a subsequent treatment strategy for varicose veins of the lower extremities is prescribed.

Additional diagnostic methods

You can undergo varicose diagnostics in the clinic using photoplethysmography (a sensor with infrared radiation is attached to the patient's skin, on the inner side of the lower leg, and the degree of light emitted depends on the degree of pathology).

After that, the speed of filling the veins with blood is determined, from the heart to the vessels. Have healthy person this process takes more than 25 s., and a patient with varicose veins - less than 10 s.

The venous plethysmography method measures the volume of blood in the veins of the legs. The device is attached to the lower leg and the cuffs are used to regulate blood flow. If the veins are healthy, then their filling is 2.5-5 ml / 100 ml of tissue; if they are sick, then their filling with blood is higher by several indicators.

No less effective research is rheovasography. It consists in the impact on the affected areas of high-frequency current pulses, based on the shape of the curve, the nature of the rise and fall, varicose veins are determined.

During the check, the patient lies down on the couch, lower limbs are disinfected with alcohol, sensors are installed on the legs, and a series of synchronous waves is displayed on the screen. By the nature of the image, it makes a diagnosis.

Valsalva technique

This test is called the famous anatomist A.M. Valsalva, was originally intended for the diagnosis and treatment of otitis media. Today the test is used much more widely.

The Valsalva maneuver helps to determine the state of the venous valve apparatus circulatory system... A huge advantage of the method is the high efficiency of the diagnostic examination.

How is the test done?

The patient breathes in and out quickly and deeply, alternately closing his mouth and nose. After that, the indicators of the cardiovascular system are measured, and on the basis of the data, a conclusion is made about the patient's condition.

What indicators can be obtained as a result of the Valsalva technique:

• Vein lumen and diameter;
• The size of the blood clot in the vessels;
• Heart rate;
• Intravenous and intra-arterial pressure.

Attention!

If you continue trying Valsalva long time, without the supervision of a doctor, then the volume of blood that comes back will greatly decrease, which can lead to a decrease blood pressure, loss of consciousness, up to cardiac arrest.

Contraindications to this method:

• Infectious diseases in the acute stage;
• High body temperature;
• Blood poisoning;
• Heart attack, stroke;
• Retinal disorders.

After the examination, the specialist visually examines the veins, probes sore points, and makes a diagnosis. If the sample is positive, then the person's venous system is at risk. The doctor prescribes adequate treatment, with a choice of complex methods regarding the general condition of the patient.

Unlike other diagnostic methods, the Valsalva test allows you to determine abnormalities in the work of the vascular valves, to identify the presence of blood clots in the early stages of the onset of the disease.

Human health is the main value in life, and therefore the earlier the disease is detected, the higher the chances of its complete elimination. Varicose veins are not a sentence, but an impetus for changing lifestyle, nutrition, refusal bad habits.