On Thursday, the White House announced that President Donald Trump has been diagnosed with chronic venous insufficiency (CVI). During a news conference, Press Secretary Karoline Leavitt shared a letter from Trump's physician, indicating that the president was examined after experiencing mild swelling in his legs. Leavitt emphasized that the physician characterized this condition as benign and quite common, particularly among adults over the age of 70. She assured the public that the president is in excellent health and noted that the complete letter from the doctor would be released soon.
Chronic venous insufficiency is a circulatory disorder that occurs when the veins in the legs struggle to return blood to the heart due to damaged valves. According to Dr. Andrea Obi, a vascular surgeon at the University of Michigan Health Frankel Cardiovascular Center, veins have valves that help transport blood back to the heart. This is distinct from arteries, which have a different function in the circulatory system.
Dr. Obi explains that the deep veins are responsible for carrying the majority of blood back to the heart, while superficial veins lie just beneath the skin's surface. When these valves malfunction, blood can pool in the legs, leading to symptoms associated with venous insufficiency. This condition affects a significant portion of the population, with estimates suggesting that up to 40% of Americans may experience CVI. This figure could be understated, as CVI often goes undetected in routine screenings, requiring a duplex ultrasound for accurate diagnosis.
Many individuals with chronic venous insufficiency experience mild symptoms. The most prevalent sign is the presence of varicose veins, which develop when blood accumulates in the superficial veins, causing them to swell. Patients may report feelings of heaviness, discomfort, or pain in the affected areas. If the CVI affects deeper veins, swelling may occur around the ankle and can extend toward the knee, as noted by Dr. Obi.
In more severe cases, patients may notice skin darkening or the formation of open sores and ulcers. Dr. Obi highlights that blood pooling near the ankle can lead to a brown discoloration of the skin, resulting from iron deposits from red blood cells. Over time, this condition can cause the skin to thicken, making it less capable of healing from minor injuries, thus leading to ulcer formation.
Treatment for chronic venous insufficiency is typically non-surgical and focused on preventing swelling and ulcer formation, according to the Society for Vascular Surgery. Dr. Obi states that if a patient discovers they have CVI but exhibits no symptoms, treatment is unnecessary until symptoms manifest.
The initial approach to managing CVI often involves compression therapy, such as wearing compression stockings or using elastic wraps. In some cases, supplements may also be recommended to alleviate symptoms. Dr. Obi emphasizes the importance of compression as a first-line treatment. If patients continue to experience symptoms or find it challenging to carry out daily activities, further interventions may be considered.
For those with affected superficial veins, vein ablation—a minimally invasive procedure to close off problematic veins—may be performed, alongside the removal of varicose veins. In instances where deep veins are involved, patients may require procedures such as angioplasty to widen narrowed or blocked veins or stenting to restore proper blood flow.
Even if an individual’s vein valves are predisposed to failure due to genetic factors or aging, maintaining an active lifestyle can significantly aid in managing CVI. Dr. Obi advises that walking can effectively compensate for valve failure, as the calf muscles help push blood back to the heart. She recommends that patients engage in a walking program to strengthen their calf muscles, noting that prolonged standing can exacerbate the condition by allowing blood to pool in the legs.
In summary, while chronic venous insufficiency is a common condition, understanding its symptoms, treatment options, and preventive measures can empower individuals to manage their health effectively. As President Trump continues to navigate his diagnosis, public interest in CVI and its implications remains high.
