Chronic Venous Disease (CVD)

Diagnosis

If you have pain and discomfort in your legs or you’re at risk for venous disease, your doctor will take the following steps to confirm or rule out a diagnosis of this condition: 

• Review your medical history – Venous disease runs in families, and can also be caused by environmental factors such as a recent surgery. A close review of your medical history will alert your doctor to these and other potential risk factors for venous disease.
• Perform a physical exam – In addition to checking your pulse, blood pressure, temperature, and possibly ordering blood tests, your doctor will also check the color and texture of your skin and look for any sores, signs of infection, varicose veins, or spider veins.
• Perform a handheld Doppler ultrasound test – Your doctor will perform this test to listen to blood flow.
• Order a duplex ultrasound – This test will help your doctor diagnose venous disease by showing both superficial and deep veins, how your blood flows through your body, if blood flow is blocked or flowing in the wrong direction (venous reflux), and if valves are working.
• MRI or CT of veins—These tests will look at the deep veins in the pelvis and abdomen.
• Use venography – Your doctor will use this invasive X-ray test to look at the flow of the venous system and potentially correct the flow if a blockage is identified.
• Take venous pressure measurements – These measurements will help your doctor determine the health of your leg veins.

Additional tests

If you have symptoms of a pulmonary embolism (PE), such as trouble breathing or coughing up blood, you may be given these additional tests:

• Duplex ultrasound test – (see diagnosis section)
• Spiral computed tomography (CT) scan – This noninvasive procedure uses special X-ray equipment to produce detailed cross-sectional images of the body, specifically of your lung arteries to look for a clot.
• Electrocardiogram (ECG/EKG) – This test records the electrical activity in your heart and can detect abnormalities in your heart's rhythm and certain patterns that suggest portions of the heart may not be getting enough blood flow.
• Echocardiogram—This ultrasound-based, non-invasive test will look at your heart muscle function and look for signs of strain on the heart from the PE.
• Magnetic resonance venography (MRV) – This noninvasive test uses magnetic fields and radio waves to produce 3D images of the veins. These images provide doctors with a more precise assessment of the severity and location of any blockages in the veins.