Chapter 19: Chronic Venous Insufficiency and Lymphedema
ANA I. CASANEGRA, MD; SUMAN RATHBUN, MD
A 45-year-old female presents to your office with complaints of leg swelling and pain. She describes progressive dependent pain and swelling in the legs since her last pregnancy, 20 years ago. The swelling worsens throughout the day, improves with leg elevation, and is worse in the left leg, where she had a deep vein thrombosis after the delivery of her fourth child.
For the last several years, she has had disabling exertional pain in the left calf that is incompletely relieved with sitting and leg elevation.
She has 4 children, with no miscarriages. Her family history is negative for venous thromboembolism, but her mother has varicose veins and ulcers in her legs.