On the Occurrence of Dyspnea, Dizziness and Precordial Distress Occasioned by the Pooling of Blood in Varicose Veins.

Varicose veins of the legs are known to have local secondary effects such as edema of the leg, eczema of the skin, ulceration and even hemorrhage. Sequelae such as thrombosis and phlebitis of the enlarged veins may in turn cause pulmonary emboli with their distressing pulmonocardiac symptoms. However, we can find no clear evidence in the medical literature that the pooling of blood in varicose veins leads to a decrease in the efficiency of cardiac and circulatory function.' It is our intention to present here evidence, both clinical and physiological, indicating that such a form of circulatory embarrassment occurs in varying degrees in persons who have varicose veins. The failure in the past to recognize this type of decrease in circulatory function may be due in part to the fact that the symptoms are usually moderate in nature and seldom lead to actual cardiac failure. However, fatigue, dyspnea, dizziness, fainting and precordial distress are symptoms that may trouble the patient in whom the heart is burdened to maintain its compensation. These symptoms should be recognized as possibly being the effect of pooling of blood in varicose veins. Surgical treatment of such patients should restore their hemodynamics toward normal and thus bring relief from their symptoms, provided that the heart has not been permanently damaged. In the aged and in those with known heart disease,