ABSTRACT
This chapter describes an orderly process of making a diagnosis for a patient with chronic venous disease (CVD). It focuses on telangiectasia, varicose veins, and venous ulcers. CVD is a common affliction, with telangiectasia being found in the large majority of people who are over 60 years old. Patients presenting with venous ulcers should be questioned in a similar manner. Other pertinent questions relevant to a venous ulcer include location, size, appearance, and whether there are signs and symptoms of infection present. Clusters of telangiectasias can appear as skin blemishes or venous lakes. Varicose veins that continue to be visualized or are slow to dissipate may also suggest the presence of significant venous obstruction. Venous outflow is typically measured with impedance and strain gauge plethysmography. Increased resistance to venous outflow in combination with valvular incompetence can be responsible for the more recalcitrant ulcer. The chapter discusses the algorithm emphasizes diagnostic options in a logical order.
