Combination of the right heart pathology and varicose disease as a factor of development of trophic changes in the lower extremities: a case report

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Abstract

Varicose disease is the most prevalent vascular disorder affecting lower extremities. Chronic venous insufficiency (CVI) is common in subjects with incompetent superficial and perforator veins. Major attention in pathogenesis of CVI is paid to horizontal venous reflux, while pathological blood flow in the superficial veins may sometimes be regarded as a postural reaction. At the same time cardiac pathology may also attribute to the development of CVI. The article presents a case report describing a female patient with combination of the right heart pathology and varicose disease associated with tricuspid regurgitation leading to constant venous reflux in the lower extremity superficial veins with further development of trophic changes.

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About the authors

Roman E. Kalinin

Ryazan State Medical University

Email: nina_mzhavanadze@mail.ru
ORCID iD: 0000-0002-0817-9573
SPIN-code: 5009-2318
ResearcherId: M-1554-2016

MD, professor, head. Department of Cardiovascular, Endovascular, Surgical Surgery and Topographic Anatomy

Russian Federation, Ryazan

Igor A. Suchkov

Ryazan State Medical University

Email: nina_mzhavanadze@mail.ru
ORCID iD: 0000-0002-1292-5452
SPIN-code: 6473-8662
Scopus Author ID: M-1180-2016

MD, PhD, Professor, Professor of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy

Russian Federation, Ryazan

Malay D. Patel

Apollo Hospital

Email: info@drmalaypatel.com
ORCID iD: 0000-0002-9119-9400

MD, PhD, Professor, Vascular Surgeon

India, Ahmedabad, Gujarat

Ivan N. Shanaev

Ryazan State Medical University

Author for correspondence.
Email: c350@yandex.ru

MD, PhD, Assistant Professor of the Department of Cardiovascular, X-Ray Endovascular, Operative Surgery and Topographic Anatomy

Russian Federation, Ryazan

Nina D. Mzhavanadze

Ryazan State Medical University

Email: nina_mzhavanadze@mail.ru
ORCID iD: 0000-0001-5437-1112
SPIN-code: 7757-8854
ResearcherId: M-1732-2016

MD, PhD, Associate Professor of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy; Senior Researcher at the Central Research Laboratory

Russian Federation, Ryazan

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Supplementary files

Supplementary Files
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1. Fig. 1. Sonogram of the left SFJ: a) B-mode: 1 – SFJ, 2 – common femoral vein, 3 – common femoral artery, 4 – anterolateral tributary of the great saphenous vein (GSV), 5 – GSV; b) C-mode, Valsalva maneuver

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2. Fig. 2. Sonogram indicating a pseudo pulsatile blood flow pattern in the great saphenous vein

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3. Fig. 3. Sonogram indicating a biphasic flow in the superficial femoral vein: antegrade flow below the zero line; retrograde flow with valve closure – above the zero line

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4. Fig. 4. Echocardiogram: а) Apical four chamber view, b) Subcostal four chamber view indicating tricuspid regurgitation (regurgitant jet along the interatrial septum)

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5. Fig. 5. Sonogram indicating a pseudo pulsatile blood flow in the inferior vena cava

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6. Fig. 6. Sonogram indicating a pseudo pulsatile blood flow in the hepatic veins

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7. Fig. 7. Clinical presentation of the female subject

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