Varicose veins are dilated, enlarged veins that occurs when blood pools in the veins because the vein valves are not working properly. Therefore, in most cases varicose veins will be visible as bulging blue veins on the surface of your legs. The bulging veins will be most noticeable when you are standing because gravity will cause more blood to pool when you are in this position. Varicose veins may disappear when you lie down because the pooling blood will drain out of the veins. Varicose veins are usually tortuous or twisted, but sometimes can be fairly straight. In some cases, the varicose veins occur only below the surface of the skin and thus may not be visible. In such cases the varicose veins may only be detectable by good physical examination and with the use of an ultrasound machine. It may be appropriate to have an evaluation to determine if such veins exist if you have leg symptoms such as heaviness, fatigue, pain or night cramps, or if you have leg swelling, inflammation, phlebitis, or ulceration. Finally, one can have pelvic varicose veins, with symptoms such as pelvic pain and pelvic congestion syndrome. Specialized ultrasound and other imaging techniques may be needed to diagnose pelvic varices.
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