What is chronic venous insufficiency, the condition Trump was diagnosed with?

President Donald Trump has been diagnosed with chronic venous insufficiency — a condition that develops when valves in the leg veins malfunction, leading to blood collecting in the legs. It is a common condition, but severe cases can lead to complications, doctors said.

In some cases, chronic venous insufficiency can be a sign of a more serious condition such as problems with the heart, liver or kidneys, said Alisha Oropallo, a vascular surgeon at Northwell Health and a professor of surgery at the Zucker School of Medicine at Hofstra University who wrote a 2022 review on managing the condition.

Chronic venous insufficiency “is not dangerous per se, but it can lead to long-term complications if left untreated, namely ulcerations, severe leg swelling that can be pretty debilitating for some people,” said Thomas Maldonado, medical director of the Venous Thromboembolic Center at NYU Langone Health.

Anywhere from 10% to 30% of Americans will have “some form” of chronic venous insufficiency over the course of their life, he said.

We asked physicians about symptoms, including swelling, risk factors and treatment for chronic venous insufficiency.

What is chronic venous insufficiency?

Chronic venous insufficiency occurs when there is high pressure in the veins, which are the blood vessels that recirculate blood from the body back to the heart.

Veins have one-way valves that prevent blood from flowing backward, but the pressure can cause the valves to weaken and become “leaky,” Maldonado said, leading to blood pooling in the legs.

“They’re delicate little valves, almost like little tissue paper, one-way valves, that catch the blood as it tries to reflux back down to the ankles,” he said.

Chronic venous insufficiency is “a dysfunction in the valves of your veins,” Oropallo said.

What are the symptoms of chronic venous insufficiency?

Symptoms of chronic venous insufficiency include aching, throbbing or a feeling of fatigue in the legs, said Chelsea Dorsey, the director of the Vein Clinic at UChicago Medicine.

Swelling, skin discoloration and varicose veins are other signs, experts said.

“The valves become incompetent, and then, over time, the red blood cells leak from the veins into the skin and they turn from the oxidation of the air, they turn from a red color to a brownish hue in the skin … tattooing the skin dark” and becoming permanent, Oropallo said.

Is chronic venous insufficiency dangerous?

Chronic venous insufficiency is not dangerous for most people, Dorsey said, but “in some patients with more advanced stages of the condition, they can be more prone to skin infections or may develop difficult to heal ulcers.” The condition also puts some people at “increased risk for developing blood clots,” she said.

Chronic venous insufficiency could also be an indication of problems in the heart, kidneys or liver in some people, Olopallo said.

“The veins bring the blood back into the heart, and any kind of obstruction or pressure to the area could cause or create a backflow problem,” Oropallo said. When blood cannot get back up to the heart, it can “cause pressure on the healthy veins and cause them to become diseased,” she said.

What are the risk factors for chronic venous insufficiency?

“There’s a big genetic component to this,” Maldonado said. Some people are at a higher risk of developing it, and varicose veins, because of family history, he said. And the condition is more prevalent as people age.

“It’s really one of these insidious diseases that can creep up as we age,” Maldonado said.

Pregnant people and individuals who are overweight are also at increased risk of the condition.

Other risk factors include a history of blood clots and spending long periods of time on one’s feet, the experts said.

People who stand a lot for work, such as nurses, physicians and teachers, or those who do prolonged sitting, such as bus drivers, are “more likely to get venous insufficiency,” Oropallo said. “And this can also cause, with the lack of movement, blood clots.”

A history of blood clots can damage those valves and then later on lead to this chronic venous insufficiency, she said.

“Most people experience these changes over decades. It doesn’t just happen in one day,” Oropallo said.

What is the treatment for chronic venous insufficiency?

Regular use of compression stockings, leg elevation, exercise and weight loss can help with the condition, the experts said.

“In circumstances where someone’s symptoms are impacting their quality of life, some minimally invasive procedures may be effective to close the veins in the legs that are not functioning well in an effort to ‘reroute’ the blood flow to a more efficient path,” Dorsey said in an email.

Early screening is important, Oropallo said. If someone has symptoms such as pain, numbness, tingling, heaviness or fatigue in the legs, they can “ask if the compression stockings are right for them or if they need a subsequent ultrasound,” she said.

The condition can be detected with an ultrasound, called a venous reflux study, which assesses “the incompetence of the veins,” Oropallo said.

“Lifestyle plays a significant role, not just genetics, but a healthy lifestyle like regular exercise, maintaining healthy weight, and avoiding that prolonged immobility can help and prevent or manage the chronic venous insufficiency as well,” she said.