Is a Ruptured Varicose Vein a Medical Emergency?
Medically reviewed by Robert J. Anderson, MD, RVT, RPVI, on March 6, 2024
Varicose veins, those bulging, twisted blue, red, or purple varicosities (swollen veins) snaking across your legs, while typically not a life-or-death matter, are often more than just a mere cosmetic concern. Envision your varicose veins. Now, imagine the shock of seeing a large pool of discoloration just under your skin or experiencing a significant amount of bleeding from your leg vein that is difficult to stop. This is what can happen when an untreated varicose vein ruptures.
This blog will explore the risks and treatment of a ruptured varicose vein with a board-certified vein specialist, Dr. Robert Anderson. Known as “Dr. Bob” to the patients and staff, he is the lead physician at the Springfield, Massachusetts, Center for Vein Restoration (CVR) vein clinic location.
What veins can rupture in the leg?
Dr. Anderson: There are three types of abnormal veins. The first is spider veins, which are less than one millimeter in size. The next are reticular veins, which are one to three millimeters in size. Last, there are varicose veins, which are greater than three millimeters in diameter. All three of these vein types can potentially rupture and cause bleeding.
What are the symptoms of a ruptured varicose vein?
Dr. Anderson: The most obvious sign is internal or external bleeding. Most typically, vein rupture occurs in patients with bad vein disease for several years, and these diseased veins have damaged the skin around their ankles. The most common scenario of ruptured varicose veins is when the patient has taken a shower and is toweling off down by their ankle. Then, suddenly, significant bleeding starts. The blood comes from the smaller veins; however, the pressure is so high that it can squirt across the room.
What are the causes of a varicose vein rupture?
Dr. Anderson: The most common cause is neglected vein disease. Vein disease, also known as venous insufficiency, occurs when the veins fail to return blood to the heart efficiently. This dysfunction often leads to symptoms such as varicose veins, leg swelling, and discomfort. Without proper treatment, vein disease can progress, causing more severe complications such as venous ulcers and blood clots. Vein disease damages the skin over the long term, and the skin is our protection against bleeding and ulcer formation, so we don't run into problems with those things.
When is a ruptured varicose vein a medical emergency?
Dr. Anderson: Significant bleeding is the most common reason a ruptured vein becomes a medical emergency. If you lose a lot of blood, obviously, that can even be life-threatening. When dealing with a bleeding vein, the easiest way to stop the bleeding, if you're by yourself, is to lay down and elevate your leg above your heart. This relieves the pressure off the venous system. If somebody is available to help with that, or if you've got it elevated and you can bend up enough to put pressure on it, that'll also stop the bleeding.
What are the potential complications of a ruptured varicose vein?
Dr. Anderson: There are several. The first is bleeding from smaller veins that the pressure head feeds into. Another is blood clots, a significant problem for people across the country. They are not always related to varicose veins, but if you have varicose veins, you are at a fourfold greater risk for blood clots than if you didn't.
The other major problem that venous disease causes is damage to the skin, which can lead to venous ulcers and sores down at the ankle. These are very painful, and once they occur, the patient experiences constant pain. However, the expert vein specialists at Center for Vein Restoration provide lasting relief and facilitate healing, ultimately allowing patients to regain comfort and mobility in their daily lives.
Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR near you.
What immediate actions should be taken if a varicose vein ruptures?
Dr. Anderson: As I mentioned, elevating your leg above your heart is the best thing to do. That takes the pressure out of the blood vessels. If somebody is available to help, they can put pressure on the area. Then, wrap an ACE wrap around the area. This is an easy way to stop the bleeding. Fortunately, most people have ACE wraps around their house. It’s essential to keep the leg elevated after applying the wrap.
The other option is using an ice pack. Cold constricts the veins, making them less likely to bleed. A helpful blood clot can form to prevent the bleeding from continuing.
NOTE: Blood clots are often thought of in negative terms. However, they are necessary to stop bleeding and start healing. This helpful clot then dissolves once the healing begins. According to the Cleveland Clinic, normal, necessary blood clots are the first line of defense if something damages your delicate blood vessels.
A blood clot only becomes dangerous when it forms where it is not needed inside the blood vessel. If this type of clot doesn’t dissolve, it can break off and block vital blood flow to the heart, lungs, or other organs. This is a medical emergency called deep vein thrombosis (DVT).
NOTE: To avoid a lengthy and costly trip to the emergency room, Center for Vein Restoration offers a DVT rule-out service for individuals who suspect they have a DVT. This one-stop management approach includes a scan and treatment anticoagulation, education, and follow-up if needed. Call the DVT hotline at 877-SCAN-DVT (877-722-6388).
How is a ruptured varicose vein treated?
Dr. Anderson: If you go into the emergency room, they'll probably just put pressure on it. Sometimes, they'll put a suture in it to try and stop it from bleeding. If you come to a vein center such as Center for Vein Restoration (CVR), we’ll apply pressure and inject the veins feeding into the area to close the bleeding vein down. We call that sclerotherapy.
Once the bleeding is controlled, the patient must treat the underlying problem, which is the bigger varicose veins. To do that, the patient will need a detailed leg ultrasound to identify all the problem veins, develop a treatment plan, and shut them down to prevent future bleeding problems.
Do treatment options differ for un-ruptured veins and ruptured varicose veins?
Dr. Anderson: If a ruptured varicose vein is bleeding externally, stopping the bleeding is the most important task. The treatment options for ruptured and varicose veins that haven’t ruptured are virtually the same.
Center for Vein Restoration offers a variety of outpatient treatments for varicose veins that allow patients to return to their normal routine with minimal disruption to daily activities. Procedures such as endovenous thermal ablation and ultrasound-guided foam sclerotherapy are commonly performed in the office. These minimally invasive techniques target dysfunctional veins, closing them off or removing them entirely, thus reducing symptoms and improving the appearance of varicose veins.
Dr. Anderson: The biggest thing is keeping the skin as healthy as possible. If you have vein disease, it tends to dry the skin, especially in the wintertime, so moisturizing the skin at least once a day is helpful.
Compression is the other big thing that is a mainstay in almost everything we do with varicose veins. Compression stockings that are what we call graduated are at a higher pressure at the ankle, less high as they go up either to the knee area or above the knee into the thigh area.
What happens if a varicose vein is injured?
Dr. Anderson: One thing that also can occur—it's less likely, and it's usually related to a little bit of trauma, it could be mild trauma, but it could be a little bit more significant—is directly traumatizing a varicose vein. That can lead to bleeding underneath the skin that won't come out. In that case, you'll get a severe bruise. And if you're on a blood thinner, you could have a collection of blood we call a hematoma in the area. Again, ice and direct pressure to the area will control it because it's a low-pressure system.
Trauma to varicose veins can lead to blood clots due to vein damage and increased pressure. These clots may extend into surrounding veins, posing a risk of dangerous complications. Symptoms such as redness or hard lumps resembling blood clots should prompt immediate evaluation to prevent further complications. The symptoms you are looking for are developing redness in the area or hard lumps that feel like blood clots on the surface, and if you are, you should be evaluated.
NOTE: Symptoms of blood clots include:
- Swelling: Noticeable swelling in the affected area, often accompanied by pain or tenderness.
- Redness or discoloration: Skin may appear reddish or have a distinct discoloration compared to the surrounding area.
- Pain or tenderness: Persistent pain or tenderness, especially when touching or applying pressure to the affected area.
- Warmth: The affected area may feel warm to the touch, indicating inflammation and increased blood flow.
- Skin changes: Changes in skin texture, such as tightness or a shiny appearance, may be present.
- Visible Veins: Veins may become more visible or prominent in the affected area.
- Difficulty breathing: When blood clots occur in deep veins, symptoms may include difficulty breathing, chest pain, or coughing up blood (symptoms of a pulmonary embolism).
If you experience any of the above symptoms, especially in combination, it's essential to seek medical attention promptly to prevent potential complications. Call the DVT hotline at Center for Vein Restoration at 877-SCAN-DVT (877-722-6388).
Treat varicose veins before they become a medical emergency
Don't wait for varicose veins to escalate into a medical emergency! At the Center for Vein Restoration, our expert team provides expert diagnosis and personalized treatment plans that prioritize your well-being and alleviate discomfort while improving your vein health.
By seeking timely intervention, you can prevent complications such as blood clots and ensure long-term leg health and confidence. Take the first step towards healthier legs by scheduling a consultation with the Center for Vein Restoration today. CVR accepts many insurances, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, Medicare, and more.
Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR near you.