Many patients who come for evaluation are concerned about whether the presence of their enlarged, bluish varicose veins predispose them to blood clots that could, “go to my heart”.

The short answer is:  unlikely.

The main reason to be concerned about varicose veins is that they often progress and cause substantial symptoms such as pain, skin changes, ulceration, leg swelling, itching, leg heaviness and aching.   We customarily treat the varicose veins and their underlying causes with the goal to relieve symptoms and to prevent further progression of problems.

However, these bulging veins that sit under the skin can occasionally develop small, usually painful blood clots lying within the confines of the vein.  Under these circumstances, we recommend the patient promptly see a vein specialist to obtain a detailed ultrasound (soundwave) study of all of the veins in the effected leg.  In about 5-10% of cases, the clots in these superficial veins will spread to the deeper veins of the leg which often cannot be discovered without performing the ultrasound exam.  It is the discovery of blood clots in the deeper veins of the leg, especially if above the knee, that can result in a clot traveling to the heart or lungs.

Still, this is a rare event and can be prevented by doing an ultrasound exam and if indicated prescribing a short course (two weeks) of blood thinner medication.

In summary, varicose veins themselves are not a strong predictor of  blood clots.  However, if a varicose vein develops a clot, a prompt evaluation is indicated to prevent more serious consequences.