An Uncommon Presentation of Varicose Vein: A Case Report

Chengdu, China - [2023 July]

Medical experts from West China Hospital, Chengdu, reported a highly unusual case of pulsating varicose vein, presenting with arterial-like pulsations in both superficial and deep veins of the lower extremities, which was found to be associated with severe tricuspid regurgitation. This rare clinical manifestation and its treatment were discussed in an article published by Xinpei Ren, Zhoupeng Wu, and Yukui Ma in the Iran Red Crescent Medical Journal.

The case involved a 45-year-old woman who visited the hospital with complaints of varicose veins in both lower limbs. The patient's medical history revealed a prior history of superficial varices, which worsened following pregnancy. Physical examination confirmed bilateral saphenous vein varicose veins, superficial varicose veins in the lower extremities, superficial vein dilatation of the abdominal wall, and moderate ankle edema. Further evaluation was conducted, including venous ultrasound and echocardiography.

The results of the examinations revealed arterial-like pulsatile blood flow in both the superficial and deep veins of the lower extremities, along with severe tricuspid regurgitation. The patient's condition was diagnosed as secondary varicose veins associated with tricuspid regurgitation, causing an increase in venous pressure.

Due to the patient's refusal for cardiac surgery to replace the tricuspid valve, conservative treatment was administered. Compression therapy with Covidien T.E.D Grade 2 compression stockings was prescribed, resulting in a significant improvement in the patient's symptoms.

The researchers highlighted the rarity of this clinical presentation, as pulsating varicose veins are mostly reported in association with tricuspid regurgitation or right ventricular dysfunction. A review of other reported cases in the literature supported their findings.

The authors emphasized the importance of multidisciplinary teams, including experts from cardiology, vascular surgery, and anesthesia, in the treatment of this condition. They also discussed various treatment options, such as compression therapy, sclerotherapy, and radiofrequency treatment, depending on the severity of the symptoms and associated complications.

In conclusion, the case report shed light on an uncommon presentation of varicose veins associated with tricuspid regurgitation, and the successful use of compression therapy to alleviate the patient's symptoms. Further research and collaboration among medical experts are essential to better understand and manage such rare cases.

The authors of the article declared no conflicts of interest, and the patient provided consent for the publication of her data and images.

Disclaimer: This event report is based on an article published in the Iran Red Crescent Medical Journal and is for informational purposes only. For medical advice and treatment, please consult qualified healthcare professionals.

This article is a reprint from "An Uncommon Presentation of Varicose Vein: A Case Report" by Xinpei Ren, ZhouPeng-Wu and Yukui Ma, published in the Iran Red Crescent Medical Journal, 2021 November; 23(11):e1203. The original article can be found here.