Jugular veins: anatomy, functions, possible pathology (ectasia, thrombosis, aneurysm). Why does the jugular vein in the neck enlarge? Swelling and pulsation of the neck veins
When examining the neck of a patient with aortic valve insufficiency, one can see pulsation of the carotid arteries (“carotid dancing”). In this case, a peculiar phenomenon may be observed, expressed in head shaking (Musset's symptom). It occurs due to a sharp pulsation of the carotid arteries with differences in maximum and minimum pressure. The symptom of “carotid dancing” is sometimes combined with pulsation of the subclavian, brachial, radial and other arteries and even arterioles (“pulsating man”). In this case, it is possible to define the so-called precapillary pulse(Quincke pulse) - rhythmic redness in the systole phase and blanching in the diastole phase of the nail bed with light pressure on its end.
In an upright position of the patient, pulsation and swelling of the jugular veins are sometimes detected on the neck, resulting from difficulty in the outflow of venous blood into the right atrium. When outflow through the superior vena cava is difficult, the veins of the head, neck, upper extremities, and anterior surface of the body dilate and the blood is directed from top to bottom into the inferior vena cava system.
On the neck you can notice pulsation and jugular veins ( venous pulse). Their alternating swelling and contraction reflect fluctuations in pressure in the right atrium depending on the activity of the heart. Slowing the outflow of blood from the veins to the right atrium with increasing pressure in it during atrial systole leads to swelling of the veins. The accelerated outflow of blood from the veins into the right atrium when the pressure in it decreases during ventricular systole causes collapse of the veins. Therefore, during systolic dilatation of the arteries, the veins collapse - negative venous pulse.
In a healthy person, the swelling of the veins is clearly visible if he is in a supine position. When the position changes to vertical, the swelling of the veins disappears. However, in cases of tricuspid valve insufficiency, exudative and adhesive pericarditis, emphysema, pneumothorax, the swelling of the veins is clearly visible in the vertical position of the patient. It is caused by stagnation of blood in them. For example, with tricuspid valve insufficiency, the right ventricle with each contraction throws part of the blood back into the right atrium, which causes an increase in pressure in it, a slowdown in the flow of blood into it from the veins, and severe swelling of the jugular veins. In such cases, the pulsation of the latter coincides in time with the systole of the ventricles and the pulsation of the carotid arteries. This is the so-called positive venous pulse. To identify it, it is necessary to push out the blood from the upper part of the jugular vein with a finger movement and press the vein. If the vein quickly fills with blood, this indicates its retrograde flow during systole from the right ventricle into the right atrium.
A sharp expansion of the veins of the neck with simultaneous sharp swelling (Stokes collar) is caused by compression of the superior vena cava.
Visible dilatation of the jugular veins in the standing and sitting position indicates increased venous pressure in patients with right ventricular heart failure, constrictive pericarditis, pericardial effusion, and superior vena cava syndrome.
Visible carotid pulsation may occur in patients with aortic regurgitation, hypertension, hyperthyroidism, and severe anemia.
Observation of the nature of pulsation of the veins of the neck
By the level and nature of pulsation of the veins of the neck, one can judge the state of the right parts of the heart. The pulsation of the internal jugular vein on the right most accurately reflects the state of hemodynamics. The external jugular veins may be dilated or collapsed due to extracardiac influences - compression, venoconstriction. Although the right internal jugular vein is not visible, its pulsation is judged by the oscillation of the skin over the right clavicle - from the supraclavicular fossa to the earlobe, outward from the carotid artery. Observation is carried out with the patient lying down with the torso elevated - 30-45°, the neck muscles should be relaxed (Fig. 6).
Rice. 6. Visual determination of central venous pressure (in a patient, central venous pressure = 5 cm + 5 cm = 10 cm water column)
Normally, pulsation is noticeable only in the area of the right supraclavicular fossa. For each pulsation of the carotid artery, a double oscillation of the venous pulse is noted. Unlike the pulsation of the carotid arteries, the pulsation of the vein is smoother, is not felt during palpation and disappears if the skin above the collarbone is pressed. In healthy people, in a sitting or standing position, pulsation of the veins of the neck is not visible. By the upper level of pulsation of the right internal jugular vein, you can approximately determine the value of the central venous pressure: the angle of the sternum is located at a distance of about 5 cm from the center of the right atrium, therefore, if the upper level of pulsation is not higher than the angle of the sternum (only in the supraclavicular fossa), the central venous pressure is equal to 5 cm of water column, if the pulsation is not visible - the central venous pressure is below 5 cm of water. Art. (in these cases, pulsation is noticeable only in a horizontal position of the body), if the level of pulsation is higher than the angle of the sternum, to determine the central venous pressure, add 5 cm to the value of this excess, for example, if the upper level of pulsation exceeds the level of the sternum angle by 5 cm, the central venous pressure is 10 cm ( 5 cm + 5 cm) water. Art. Normally, the central venous pressure does not exceed 10 cm of water. Art. If the pulsation of the neck veins is noticeable in a sitting position, the central venous pressure is significantly increased, at least 15-20 cm of water. Art. The venous pulse normally consists of two rises (positive waves “a” and “V”) and two
When observing the pulsation of the neck veins, it is easiest to identify: 1. Increased central venous pressure - clearly visible pulsation of the veins of the neck in a sitting position, usually swelling of the external veins of the neck. 2. A sharp decrease in central venous pressure (hypovolemia) in patients with a clinical picture of collapse or shock - absence of pulsation of the neck veins and collapse of the saphenous veins even in a horizontal position. 3. Atrial fibrillation - absence of the “a” wave of the venous pulse. 4. Atrioventricular dissociation - irregular “giant” waves of venous pulse.
When pressing with the palm of your hand on the abdomen in the area of the right hypochondrium, the so-called hepatojugular reflux is noted - an increase in the level of pulsation of the veins of the neck. Normally, this increase is short-term, but in patients with congestive heart failure it persists throughout the entire time of pressure on the liver area. Determination of hepatojugular reflux is carried out in patients with normal central venous pressure, for example, after taking diuretics.
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Subcutaneous fat
When examining subcutaneous fat tissue, attention is paid to the degree of development, places of greatest fat deposition and the presence of edema.
Obesity - excessive development of subcutaneous fat, which leads to weight gain. The degree of development of subcutaneous fat is currently assessed by calculating the so-called body mass index (BMI), which is defined as the quotient of body weight (in kilograms) divided by body surface area (in m2), which is determined using special formulas or nomograms. In table 1 presents the classification of overweight and obesity depending on the BMI value.
Table 1. Classification of overweight and obesity depending on BMI (WHO, 1998)
As BMI increases, the risk of developing severe cardiovascular diseases, complications and death increases. The highest risk is observed with the abdominal type of obesity, to identify which the ratio of the waist circumference to the circumference of both hips is read. Normally, this ratio is 1.0 for men and 0.85 for women.
Edema can occur with various diseases of internal organs. The severity of edema syndrome can vary: from slight pastiness of the subcutaneous tissue to anasarca with severe edema and accumulation of fluid in the serous cavities (ascites, hydrothorax, etc.). It should be remembered that the body of an adult can retain up to 3-5 liters of fluid without the appearance of swelling visible to the eye and palpable ("hidden edema").
Ways to detect edema:
Palpation method - pressing with the thumb on the skin and subcutaneous tissue in the area of the ankles, legs, sacrum, sternum, where dimples remain in the presence of edema;
Monitoring the dynamics of body weight;
Measuring the amount of fluid you drink and urine output (diuresis).
The last two methods are most suitable for identifying hidden edema.
Swelling of the neck veins
This is an important sign of blood stagnation in the venous bed of the systemic circulation and an increase in central venous pressure (CVP). An approximate idea of its size can be obtained by examining the veins of the neck. In healthy individuals, in a supine position with the head of the head slightly elevated (at an angle of approximately 45°), the superficial veins of the neck are not visible or are filled only within the lower third of the cervical section of the vein approximately to the level of a horizontal line drawn through the manubrium of the sternum at the height of the angle of Louis ( II rib). When raising the head and shoulders, the filling of the veins decreases and disappears in an upright position. When venous blood stagnates in the systemic circulation, the filling of the veins is significantly higher than the level of the angle of Louis, remaining when the head and shoulders are raised and even in a vertical position.
A positive venous pulse is most often detected with tricuspid valve insufficiency, when during systole some of the blood from the right ventricle (RV) is thrown into the right atrium (RA), and from there into large veins, including the veins of the neck. With a positive venous pulse, the pulsation of the neck veins coincides with ventricular systole and the carotid pulse.
Abdominal-jugular (or hepato-jugular) reflux
Its presence indicates increased central venous pressure. An abdominal-jugular test is carried out during quiet breathing by briefly (for 10 s) pressing the palm of the hand on the anterior abdominal wall in the peri-umbilical region. Normally, pressure on the anterior abdominal wall and an increase in venous blood flow to the heart with sufficient contractility of the pancreas are not accompanied by swelling of the neck veins and an increase in central venous pressure. Only a small (no more than 3-4 cm H2O) and short-term (the first 5 s of pressure) increase in venous pressure is possible. In patients with biventricular (or right ventricular) CHF, a decrease in the pumping function of the pancreas and stagnation in the veins of the systemic circulation, when performing the test, the swelling of the neck veins increases and the central venous pressure increases by at least 4 cm water column. Positive test results indicate the presence of stagnation in the veins of the systemic circulation caused by right ventricular failure. A negative test result excludes heart failure as a cause of edema.
Thus, the appearance of patients with biventricular (left and right ventricular) CHF is very characteristic. They usually assume an orthopneic position with their legs down. They are characterized by severe swelling of the lower extremities, acrocyanosis, swelling of the neck veins, a noticeable increase in the volume of the abdomen due to ascites, and sometimes swelling of the scrotum and penis in men. The face of patients with right ventricular and total heart failure is puffy, the skin is yellowish-pale with pronounced cyanosis of the sub, tip of the nose, ears, the mouth is half open, the eyes are dull (Corvisar's face).
A.V. Strutynsky
Complaints, anamnesis, physical examination
Pulsation and swelling of the neck veins are typical symptoms of increased central venous pressure. In a healthy person, this phenomenon is quite likely; it can be observed in the neck area, four centimeters from the angle of the sternum. The patient must lie on a bed with the head of the bed raised at an angle of 45 degrees. This position of the body ensures a pressure in the right atrium of ten centimeters of water. Pulsation in the neck veins should disappear when the body is moved to an upright position.
Increased venous pressure is characteristic of cardiac right ventricular failure. In such a situation, pulsation may be felt in the angle of the lower jaw. In some cases, venous pressure increases so much that the veins can swell under the tongue and on the back of the hands.
Stagnation of blood in the systemic circulation leads to the fact that the veins in the neck can expand and inflate. A similar pulsation occurs when blood returns to the right atrium from the right ventricle.
Signs and symptoms
The main signs of pulsation and swelling of the neck veins include:
- Swelling in the neck area.
- Slow visible pulsation and swelling of the neck veins to the angle of the lower jaw, and in some cases in the sublingual area.
- Kussmaul's sign - swelling of the veins when sighing.
- Pressure on the right hypochondrium causes swelling of the veins of the neck.
- Swelling in the neck area.
- Visible heart pulsation can be observed on the anterior chest wall.
Causes of the disease
Swelling of the veins in the neck can be unilateral or bilateral. The reasons are as follows:
- unilateral - large goiter; on the left side, an aortic aneurysm compresses the left brachiocephalic vein.
- bilateral - accumulation of fluid in the heart sac; cardiac right ventricular failure; venous pulse; constructive pericarditis; impaired blood patency in the superior vena cava; enlarged lymph nodes in the upper mediastinum; lung tumor; thrombophlebitis of the superior vena cava; mediastinal fibrosis; stenosis; pulmonary hypertension; Tension pneumothorax.
Most often, swelling of the veins in the neck is caused by the following pathological conditions:
- heart failure;
- acquired and congenital heart defects;
- hepatojugular reflux;
- cardiac tamponade;
- tumor in the mediastinum;
- arrhythmia.
- Blistering veins in the neck in children
A swollen vein in a child’s neck is most often a normal reaction, like in any person, to some kind of emotional stress, crying, coughing, which results in a change in pressure. Vessels with obstructed blood flow tend to increase in size. Under the thin children's skin, the vessels are better visible and the magnification is noticeably much better than in adults. However, if the veins are swollen, you need to consult a surgeon and cardiologist and do a dollarography of the vessels of the head and neck.
This phenomenon should not cause discomfort or pain in children. Over time, when the children grow up, most likely the situation will change and the vein will no longer be so noticeable.
Diagnostics
To make a correct diagnosis, it is necessary to conduct objective and subjective examinations. First of all, the renal-jugular drainage is examined to remove the obstruction causing the veins to swell. Additional research methods include: chest x-ray; echocardiography; Ultrasound of the neck and blood test for thyroid hormones; bronchoscopy; computed tomography of the chest; Ultrasound of the veins of the lower extremities.
Who to contact
If pulsation and swelling of the neck veins appear, you need to visit a cardiologist or therapist. Next, you may need to consult a cardiac surgeon, pulmonologist, rheumatologist, oncologist, or endocrinologist.
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Jugular veins (jugular, vena jugularis) - vascular trunks that carry blood from the head and neck to the subclavian vein. There are internal, external and anterior jugular veins, the internal one being the widest. These paired vessels are classified as the superior system.
The internal jugular vein (IJV, vena jugularis interna) is the widest vessel that carries out venous outflow from the head. Its maximum width is 20 mm, and the wall is thin, so the vessel easily collapses and just as easily expands under tension. There are valves in its lumen.
The IJV begins from the jugular foramen in the bony base of the skull and serves as a continuation of the sigmoid sinus. After leaving the jugular foramen, the vein expands to form the superior bulb, then descends to the level of the junction of the sternum and clavicle, located posterior to the muscle attached to the sternum, clavicle and mastoid process.
Being on the surface of the neck, the IJV is placed outside and behind the internal carotid artery, then moves slightly forward, localizing in front of the external carotid artery. From the larynx it passes in combination with the vagus nerve and the common carotid artery in a wide receptacle, creating a powerful cervical bundle, where the IJV goes from the outside of the nerve, and the carotid artery from the inside.
Before uniting with the subclavian vein behind the junction of the sternum and clavicle, the IJV once again increases its diameter (inferior bulb), and then unites with the subclavian vein, where the brachiocephalic vein begins. In the zone of inferior expansion and at the point of its confluence with the subclavian vein, the internal jugular vein contains valves.
The internal jugular vein receives blood from intra- and extracranial tributaries. Intracranial vessels carry blood from the cranial cavity, brain, eyes and ears. These include:
- Sinuses of the dura mater;
- Diploic veins of the skull;
- Cerebral veins;
- Meningeal veins;
- Orbital and auditory.
The tributaries coming from the outside of the skull carry blood from the soft tissues of the head, the skin of the outer surface of the skull, and the face. The intra- and extracranial tributaries of the jugular vein are connected through emissaries that penetrate through the bony cranial foramina.
From the external tissues of the skull, temporal zone, and organs of the neck, blood enters the IJV through the facial and retromandibular veins, as well as vessels from the pharynx, tongue, larynx, and thyroid gland. The deep and external tributaries of the IJV are combined into a dense multi-tiered network of the head, guaranteeing good venous outflow, but at the same time, these branches can serve as routes for the spread of the infectious process.
The external jugular vein (vena jugularis externa) has a narrower lumen than the internal one and is localized in the cervical tissue. It transports blood from the face and outer parts of the head and neck and is easily visible when straining (coughing, singing).
The external jugular vein begins behind the ear, or more precisely, behind the mandibular angle, then runs downward along the outer part of the sternocleidomastoid muscle, then crosses it below and behind, and above the clavicle flows together with the anterior jugular branch into the subclavian vein. The external jugular vein in the neck is equipped with two valves - in its initial section and approximately in the middle of the neck. The sources of its filling are considered to be veins coming from the back of the head, ear and suprascapular areas.
The anterior jugular vein is located slightly outside the midline of the neck and carries blood from the chin by fusion of subcutaneous vessels. The anterior vein is directed down the front of the mylohyoid muscle, just below - in front of the sternohyoid muscle. The connection of both anterior jugular veins can be traced above the upper edge of the sternum, where a powerful anastomosis is formed, called the jugular venous arch. Occasionally, two veins unite into one - the median vein of the neck. The venous arch on the right and left anastomoses with the external jugular veins.
Video: lecture on the anatomy of the veins of the head and neck
Jugular vein changes
The jugular veins are the main vessels that drain blood from the tissues of the head and brain. The external branch is visible subcutaneously on the neck and is accessible for palpation, so it is often used for medical procedures - for example.
In healthy people and small children, you can observe swelling of the jugular veins when screaming, straining, or crying, which is not a pathology, although mothers of babies often experience anxiety about this. Lesions of these vessels are more common in people of the older age group, but congenital features of the development of venous lines are also possible, which become noticeable in early childhood.
Among the changes in the jugular veins are described:
- Thrombosis;
- Dilatation (dilatation of jugular veins, ectasia);
- Inflammatory changes (phlebitis);
- Congenital defects.
Jugular vein ectasia
Jugular vein ectasia is a dilation of the vessel (dilatation), which can be diagnosed in both a child and an adult, regardless of gender. It is believed that such phlebectasia occurs when the vein valves are insufficient, which provokes an excessive amount of blood, or diseases of other organs and systems.
jugular vein ectasia
Older age and female gender predispose to jugular vein ectasia. In the first case, it appears as a result of a general weakening of the connective tissue basis of the vessels along with, in the second - against the background of hormonal changes. Possible causes of this condition also include long-term air travel associated with venous stagnation and disruption of normal hemodynamics, trauma, tumors that compress the lumen of the vein with expansion of its overlying sections.
It is almost impossible to see ectasia of the internal jugular vein due to its deep location, and the external branch is clearly visible under the skin of the anterolateral part of the neck. This phenomenon does not pose a danger to life; rather, it is a cosmetic defect, which may be a reason to consult a doctor.
Symptoms of phlebectasia The jugular vein is usually scanty. It may not exist at all, and the most that worries its owner is the aesthetic moment. With large ectasia, a feeling of discomfort in the neck may appear, which intensifies with tension or screaming. With significant expansion of the internal jugular vein, voice disturbances, pain in the neck and even difficulty breathing are possible.
Without posing a threat to life, phlebectasis of the cervical vessels does not require treatment. In order to eliminate a cosmetic defect, unilateral ligation of the vessel can be performed without subsequent disruption of hemodynamics, since the outflow of venous blood will be carried out by the vessels of the opposite side and collaterals.
Jugular vein thrombosis
This is a blockage of the lumen of a vessel with a blood clot that completely or partially disrupts the blood flow. Thrombosis is usually associated with the venous vessels of the lower extremities, but it is also possible in the jugular veins.
The causes of jugular vein thrombosis can be:
- Disturbance of the blood coagulation system with hypercoagulation;
- Medical manipulations;
- Tumors;
- Prolonged immobilization after injuries, operations, due to severe disorders of the nervous system and musculoskeletal system;
- Injection of narcotic drugs into the jugular veins;
- Taking medications (hormonal contraceptives);
- Pathology of internal organs, infectious processes (sepsis, severe heart failure, thrombocytosis and polycythemia, systemic connective tissue diseases), inflammatory processes of the ENT organs (otitis media, sinusitis).
The most common causes of neck vein thrombosis are medical interventions, installation of catheters, and oncological pathology. When the external or internal jugular vein is blocked, the venous outflow from the cerebral sinuses and head structures is disrupted, which is manifested by severe pain in the head and neck, especially when turning the head to the side, increased cervical venous pattern, tissue swelling, and puffiness of the face. The pain sometimes radiates into the arm from the side of the affected vessel.
When the external jugular vein is blocked, you can palpate the area of compaction on the neck corresponding to its course; thrombosis of the internal jugular vein will be indicated by swelling, pain, and an increased venous pattern on the affected side, but it is impossible to palpate or see the thrombosed vessel.
Signs of neck vein thrombosis expressed in the acute period of the disease. As the thrombus thickens and blood flow is restored, the symptoms weaken, and the palpable formation becomes denser and slightly decreases in size.
Unilateral jugular vein thrombosis does not pose a threat to life, so it is usually treated conservatively. Surgeries in this area are performed extremely rarely, since the intervention carries a much greater risk than the presence of a blood clot.
The danger of damage to nearby structures, nerves, arteries forces one to refuse surgery in favor of conservative treatment, but occasionally operations are performed when the vein bulb is blocked, combined with. Surgical operations on the jugular veins tend to be performed using minimally invasive methods - endovascular thrombectomy, thrombolysis.
Drug elimination of neck vein thrombosis consists of prescribing analgesics, drugs that normalize the rheological properties of blood, thrombolytic and anti-inflammatory drugs, antispasmodics (papaverine), broad-spectrum antibiotics if there is a risk of infectious complications or if the cause of thrombosis is, for example, purulent otitis media. Venotonics (detralex, troxevasin), anticoagulants in the acute phase of the pathology (heparin, fraxiparin) are indicated.
Thrombosis of the jugular veins can be combined with inflammation - phlebitis, which is observed with injuries to the tissues of the neck, violation of the technique of inserting venous catheters, and drug addiction. Thrombophlebitis is more dangerous than thrombosis due to the risk of spread of the infectious process to the sinuses of the brain; sepsis is also possible.
The anatomy of the jugular veins predisposes them to their use for drug administration, so catheterization can be considered the most common cause of thrombosis and phlebitis. Pathology occurs when the catheter insertion technique is violated, it remains in the lumen of the vessel for too long, or careless administration of drugs, the penetration of which into soft tissues causes necrosis (calcium chloride).
Inflammatory changes – phlebitis and thrombophlebitis
thrombophlebitis of the jugular vein
Most common localization thrombophlebitis or phlebitis The jugular vein is considered to be its bulb, and the most likely cause is purulent inflammation of the middle ear and mastoid tissue (mastoiditis). Infection of a blood clot can be complicated by the penetration of its fragments through the bloodstream into other internal organs with the development of a generalized septic process.
Thrombophlebitis Clinic consists of local symptoms - pain, swelling, as well as general signs of intoxication if the process has become generalized (fever, tachy- or bradycardia, shortness of breath, hemorrhagic rash on the skin, impaired consciousness).
For thrombophlebitis, surgical interventions are performed aimed at removing the infected and inflamed vein wall along with thrombotic applications; for purulent otitis, the affected vessel is ligated.
Jugular vein aneurysm
An extremely rare pathology is considered true jugular vein aneurysm, which can be detected in young children. This anomaly is considered one of the least studied in vascular surgery due to its low prevalence. For the same reason, differentiated approaches to the treatment of such aneurysms have not been developed.
Jugular vein aneurysms are found in children 2-7 years old. It is assumed that the reason for this is a violation of the development of the connective tissue base of the vein during intrauterine development. Clinically, an aneurysm may not manifest itself in any way, but in almost all children you can feel a rounded expansion in the area of the jugular vein, which becomes especially noticeable to the eye when crying, laughing or screaming.
Among aneurysm symptoms, complicating the outflow of blood from the skull, headaches, sleep disturbances, anxiety, and rapid fatigue of the child are possible.
In addition to purely venous ones, malformations of a mixed structure may appear, consisting of arteries and veins at the same time. Their common cause is trauma when a communication occurs between the carotid arteries and the IJV. Venous congestion, swelling of facial tissues, and exophthalmos that progress with such aneurysms are a direct consequence of the discharge of arterial blood flowing under high pressure into the lumen of the jugular vein.
For treatment of venous aneurysms Resection of the malformation is performed with the imposition of an anastomosis that discharges venous blood and vascular prosthetics. For traumatic aneurysms, observation is possible if surgery poses a greater risk than watchful waiting.
During a consultation with a cardiologist or surgeon, the patient may be diagnosed with an enlarged jugular vein in the neck; the causes of this phenomenon vary. Depending on the predisposing factors, a treatment regimen is prescribed.
The function of the jugular veins is to be responsible for the process of blood flow from the brain to the neck. Thanks to these blood veins, unpurified blood flows to the heart muscle so that the filtration process can take place.
Jugular veins are divided into several types:
- Internal. It is located at the base of the skull, and its end is in the region of the subclavian fossa. At this site, the vein pours unpurified blood into the brachiocephalic vessel.
- The external one begins under the auricle, goes down to the sternum and collarbone, enters the internal jugular vein, as well as the subclavian vein. This vessel has valves and processes.
- The anterior one originates from the outer part of the mylohyoid muscle and flows near the midline of the neck. This vein enters the subclavian and external, thereby forming an anastomosis.
Why is this happening
Phlebectasia disrupts the functioning of valves and blood vessels. The regulation of venous blood flow is suspended. Clots appear. With a large number of such formations, dysfunction of the entire venous network develops.
If the jugular vein is dilated even slightly, it is manifested by the following symptoms:
- swelling of the cervical vessels, their enlargement;
- the appearance of a blue sac on the upper section of the vein;
- swelling of the neck;
- a feeling of tightness that occurs when turning the head;
- breathing problems;
- pain when touching the neck;
- loss of voice.
Signs of pathology depend on the stage:
- Swelling of blood vessels in the neck. The patient does not feel any discomfort. A sign of pathology is identified during a visual examination.
- Drawing pain. The patient's intravenous pressure increases if he makes rapid and sudden head movements.
- Acute pain of high intensity. The man's voice is hoarse. Breathing is difficult.
When the left or right internal jugular vein expands, disturbances in the activity of the circulatory system occur.
Phlebectasia can occur at any age. Probable reasons:
- Injuries to the ribs on the left or right, neck, spinal column, which leads to stagnation of unpurified blood.
- History of concussion.
- Osteochondrosis in a patient.
- Pathologies of the cardiovascular system. Phlebectasia affects people with heart failure, ischemia, and hypertension.
- Endocrine pathologies.
- Prolonged work at the computer.
- Benign and malignant tumors.
The disease takes time to develop. Even if a person has predisposing factors, this does not mean that he is already sick. It is necessary to monitor your health more carefully.
Predisposing factors include:
- insufficient development of connective tissue cells;
- hormonal changes in the body;
- back injuries, including fractures;
- intervertebral hernia;
- staying in an uncomfortable position for a long time;
- wrong diet.
Hormonal causes of pathology are more common in women. During puberty and pregnancy, there is a risk that the veins will swell.
Other factors include depression and stress. The jugular veins have nerve endings. If all is well, these endings form venous vessels of high elasticity. But when a person is stressed, intravenous pressure increases, which impairs the elasticity of the veins.
Other unfavorable factors include:
- alcohol abuse;
- smoking;
- eating foods with toxins;
- increased stress on the body - at the physical and mental levels.
What to do
If an increase is noticed on the right or on the other side, there is a possibility that this is only the first stage. But you should not self-medicate. With such a sign, you need to consult a doctor, who will make a diagnosis based on a visual examination.
To identify pathology that has reached the second or third stage, research is carried out. If a patient comes to an appointment complaining of pain, there is a possibility that blood flow is disrupted. The doctor prescribes laboratory tests - CBC - and instrumental research methods:
- CTG of the skull, as well as the cervical and thoracic regions;
- Ultrasound of the same areas;
- MRI using contrast agent;
- puncture for diagnostic purposes.
Sometimes a joint consultation with a vascular surgeon, therapist, neurologist, cardiologist, endocrinologist and a doctor specializing in oncological pathologies is necessary.
When prescribing treatment, take into account:
- localization of the disease;
- research results;
- the degree to which symptoms affect the body.
For example, the presence of venous cervical seals on the right does not pose a significant threat. But the disease on the left side is more dangerous: there is a risk of lymphatic system disorders if a thorough diagnosis is carried out.
The patient may be prescribed a course of medication. Prescribe drugs that can remove inflammatory processes, eliminate swelling, and strengthen vascular walls.
If the patient is diagnosed with the third stage, surgical treatment is indicated. Operations are performed to remove the affected areas of the veins. The healthy parts of the veins are connected to form a new vessel.
The same methods are used to treat children. During therapy at an early age, surgical intervention is more often required.
What to do to prevent the disease from occurring is to take preventive measures. Among them:
- avoiding excessive physical or mental stress;
- if possible, no stress on the cervical spine if there is a predisposition to phlebectasis or primary signs of vein dilation;
- timely treatment of diseases that can lead to phlebectasis;
- Regular examinations by specialists will help identify the disease at an early stage and quickly treat it;
- maintaining a healthy lifestyle;
- moderate sports activity;
- balanced diet.
Why is the phenomenon dangerous?
It is important to prevent complications, for which you should adjust your lifestyle, especially if there were people with phlebectasis in your family.
It is especially dangerous if the pathology occurs in a child. The disease is diagnosed immediately after birth, sometimes at 3-5 years. This is indicated by tumor-like neoplasms, vasodilatation, and elevated temperature.
Thrombosis becomes a complication. A clot forms inside the vessel. This indicates the presence of chronic diseases in the body. The danger of a blood clot is that it can break off and block the functioning of vital veins.
For those who experience thrombosis, the doctor recommends anticoagulants. Antispasmodics, venotonics, and nicotinic acid are used to relieve inflammation, relax muscles, and make the blood more fluid. The drugs also help in resolving the blood clot. If the therapeutic regimen is successful, there is no need to perform surgery.
To avoid complications, when signs appear, you need to come for a diagnosis and take therapeutic measures. If you do not control the course of the pathological process, consequences arise. For example, the affected area may rupture, causing hemorrhage. The most unfavorable outcome is the death of the patient.
