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ClearRounds Health · Cardiology · Quick Reference

Venous Insufficiency

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Edema pattern, conservative therapy, compression, elevation, sodium/weight, venous reflux testing, and referral.

Last reviewed

Pending initial clinical review

Sources / guidelines to verify

  • Society for Vascular Surgery / AVF venous disease guidelines
Disclaimer: Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.

One-page reference

Draft content pending the site owner’s clinical review. Verify against the sources above and local protocol before clinical use.

1

What it is / why it matters

  • Incompetent venous valves → venous hypertension → edema, skin changes, ulcers.
  • Commonly confused with heart-failure edema and lymphedema.
2

Key diagnostic clues

  • Leg heaviness/aching worse with standing, better with elevation.
  • Varicosities, hyperpigmentation (hemosiderin), stasis dermatitis, medial malleolar ulcers.
  • Graded by the CEAP classification.
3

Initial workup

  • Clinical exam; venous duplex for reflux/obstruction.
  • Exclude DVT, heart failure, and renal/hepatic causes of edema.
4

Management framework

  • Conservative first: compression stockings, leg elevation, weight loss, exercise, skin care.
  • Treat ulcers (compression is the mainstay).
  • Endovenous ablation/sclerotherapy for symptomatic reflux refractory to conservative care.
5

Red flags / escalate now

  • Acute unilateral swelling (rule out DVT); a non-healing or infected ulcer; cellulitis.
  • Check the ABI before compression — don’t compress significant PAD.
6

Follow-up / monitoring

  • Compression adherence, ulcer healing, reflux referral.
7

Clinic pearls

  • Compression is the cornerstone — but check the ABI first.
  • Venous ulcers sit at the medial malleolus; elevation helps venous edema, not lymphedema.

Related quick references

📄 Peripheral Vascular Disease📄 PE / DVT

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ClearRounds Health · Cardiology — Venous Insufficiency Quick Reference · Last reviewed: Pending initial clinical review · Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.