How to Test for Venous Insufficiency

There is a cost of walking upright. Leg veins lack an active pumping mechanism to return blood to the heart and must rely on a series of passive valves that hold blood in place as it works its way back to the heart via the pumping action of leg muscles contracting and expanding. If valves or muscles become impaired, the blood pools in the leg veins, leading to venous insufficiency.

Instructions

Gathering Information

• 1

  Notice symptoms of possible venous insufficiency and write them down. These include swelling in the lower legs, pain, development of leg vein varicosities and skin pigment changes.

• 2

  Write down when symptoms occur and what activities bring them on.

• 3

  Make an appointment with your doctor and take your notes along with you on your office visit.

• 4

  Cooperate with your doctor for examination of not only parts presenting symptoms, but both legs and the pelvic and lower abdominal areas. Leg veins empty into veins in these areas, and there might be problems with the circulatory system. Your physician may conduct diagnostic tests to evaluate the possibility of venous insufficiency.

Tests

• 5

  Stand up for beginning the Trendelenburg test. A tourniquet is placed around the upper thigh. Then lie down with your legs elevated at a 45 degree angle. After the tourniquet is removed, record the time for leg veins to empty.

• 6

  Cough when directed for performing the cough test. The physician will be palpating the GSV (greater saphenous vein) or the SFJ (sapheno-femoral junction) to feel the impulse passing along the vein as blood pressure is increased by coughing. Valvular insufficiency may be indicated by palpating the impulse.

• 7

  Follow instructions for the percussion or Schwarz test. The doctor palpates a leg vein with one hand and taps the vein lightly on a distal segment of the vein. If an impulse is produced, this may indicate venous insufficiency.

• 8

  Talk over any further diagnostic testing the doctor wishes to carry out. Other conditions that can cause leg swelling include congestive heart failure, diabetes, blood clots in leg veins, infection, drug reactions and calf muscle injuries. Your doctor can best evaluate which tests will confirm or rule out the various conditions.

Further Testing

• 9

  Work with your doctor's office and the testing facility to schedule an appointment for tests. A minimally invasive definitive test is an ultrasound or sonogram of leg veins. Doctors specializing in vascular diseases sometimes conduct these tests in their own labs, but often they are given at an outpatient facility. Other possible tests are contrast-dye x-rays of leg veins and air plethysmography, which tracks limb volume changes.

• 10

  Get authorizing paperwork from your doctor for any necessary clinical blood or urine tests. Take them to a laboratory and follow instructions for obtaining the necessary specimens.

• 11

  Report back to your doctor to receive test results and discuss treatment options.