The Pathophysiology of CVI and DVT Term Paper

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Disorders of the Veins and Arteries

Pathophysiology of Chronic Venous Insufficiency and Deep Venous Thrombosis

The pathophysiology of Chronic venous insufficiency (CVI) is either obstruction or reflux of venous blood flow. It can develop from the protracted valvular incompetence of the superficial veins, deep veins or the perforating veins that connect them. In all these cases the result is venous hypertension of the lower extremities. The bicuspid valve which is located in the superficial and deep veins assists in ensuring that blood is pumped towards the heart and it prevents blood from refluxing towards the feet when the patient is standing in an upright position (Eberhardt & Raffetto, 2014). Perforating veins valve function by preventing the reflux of blood from the deep veins into the superficial veins. In normal conditions, when a patient is standing erect, venous return is pulsatile and the valves will open and close about 20 times per minute. Superficial vein valve failure occurs after the primary points of high leakage develop between the superficial systems and the deep system. This high pressure results in secondary valve failure when the normal superficial veins become widely dilated that the thin flaps of the venous valves will no longer make contact in the lumen of the vessel. With time these incompetent superficial veins will become visibly dilated and tortuous, and at this point, they are recognized as varicose veins.

Deep vein thrombosis (DVT) mainly develops in the calf veins and it grows in the direction of venous flow towards the heart.

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The venous valves are avascular and in conjunction with the reduced flow of oxygenated blood in the veins will predispose the endothelium to be hypoxemic. The endothelium around the valves will then respond by expressing adhesion molecules that will attract leukocytes (Line, 2001). The cells will transfer tissue factor to the endothelium, which will complex with activated factor VII in order to begin the coagulation cascade through the extrinsic pathway. In normal circumstances, there is a physiologic balance between the factors that promote and retard coagulation. However, any disturbance in this equilibrium will result in the coagulation process occurring at an expected time or in excess. In case there is a failure of the normal coagulation mechanism it might result in hemorrhage.

Venous thrombosis is a condition that occurs when there is development of a blood clot in the vein. However, when a clot forms in an artery it is referred to as arterial thrombosis. This is a dangerous condition because it can stop blood flow to the major organs like the brain or the heart.

Impact of Obesity on The Pathophysiology of CVI and DVT

Having excess weigh will add additional pounds of pressure on the body, which can cause serious exertion on the veins and their valves. If there is too much weight pushing down on the lower half of the body, there will be high pressure in the superficial veins and this will lead to….....

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