Diseases of the Blood Vessels - The inflammatory disorders

Arteritis

Arteritis , or inflammation of the arterial wall, usually results from infections (e.g., syphilis) or allergic reactions in which the body's protective agents against invading organisms, the antibodies, attack the vessel walls themselves. In these instances, the prime source of inflammation must be treated before the arterial condition can heal.

Phlebitis

Phlebitis is an inflammation of the veins, a condition that may stem from an injury or may be associated with such conditions as varicose veins, malignancies, and infection. The extremities, especially the legs, are vulnerable to the disorder. The symptoms are stiffness and hot and painful swelling of the involved region. Phlebitis brings with it the tendency of blood to form blood clots ( thrombophlebitis ) at the site of inflammation. The danger is that one of these clots may break away and enter the bloodstream. Such a clot, on the move, called an embolus , may catch and become lodged in a smaller vessel serving a vital organ, causing a serious blockage in the blood supply.

Physicians are likely to prescribe various drugs for phlebitis—agents to deal with the suspected cause of the disorder as well as anticoagulants (an-ticlotting compounds) to ward off possible thromboembolic complications.

Varicose Veins

Varicose veins, which are veins that are enlarged and distorted, primarily affect the leg vessels, and are often troublesome to people who are on their feet for hours at a time. Varicose veins develop because either the walls or the valves of veins are weakened. Some people may be born with weakened veins or valves. In others, the damage may develop from injury or disease, such as phlebitis. More women than men seem to have this condition, but it is common among both sexes. In women, the enlarged veins sometimes occur during pregnancy, but these may well diminish and disappear after delivery. Some elderly people are prone to this condition because the blood vessels lose their elasticity with aging, with the muscles that support the vein growing less sturdy.

In most instances, the surface veins lying just beneath the skin are involved. If there are no other complications, these cases are seldom serious, although they may be disturbing because of unsightliness. Physicians have remedies, including surgery, for making varicose veins less prominent.

When varicose veins become severe, it is usually because the vessels deeper in the leg are weak. Unchecked, this situation can lead to serious complications, including swelling ( edema ) around the ankles and lower legs. The skin in the lower leg may beome thin and fragile and easily irritated. Tiny hemorrhages may discolor the skin. In advanced stages, hard-to-treat leg ulcers and sores may erupt.

Most of the complicating problems can be averted with early care and treatment. Physicians generally prescribe elastic stockings even in the mildest of cases and sometimes elastic bandages to lend support to the veins. They may recommend some newer techniques for injecting certain solutions that close off the affected portion of the vein. On the other hand, surgery may be indicated, especially for the surface veins, in which the varicose section is either tied off or stripped, with the blood being rerouted to the deeper vein channels. See under “Vascular Surgery” in Ch. 20, Surgery , for more information about surgical treatment of varicose veins.

While long periods of standing may be hard on varicose veins, so are uninterrupted stretches of sitting, which may cause blood to collect in the lower leg and further distend the veins. Patients are advised to get up and walk about every half hour or so during any extended period of sitting. A good idea, too, is to sit with the feet raised, whenever possible, to keep blood from collecting in the lower legs.