Chronic venous insufficiency strengthens the thrombo-embolic risk in congestive heart failure in elderly patients

Background As for other pathologies, the pathogenesis of venous thrombo-embolism (VTE) is multifactorial. A comprehensive understanding of the pathogenesis of venous thrombosis is essential for identifying patients at increased risk as in elderly patients with congestive heart failure (CHD) and with presence of chronic venous insufficiency (IVC). Eberhard Mammen postulated immobility as the leading event in the CHD, because it reduced blood flow as a result of decreased muscle contraction. The subsequent “stasis of flow” led to accumulation of blood within the intramuscular sinuses, especially of the calf, triggering hypercoagulability due to local accumulation of activated clotting factors and coagulation activation products and the simultaneous consumption of blood coagulation inhibitors.