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President Donald Trump has been diagnosed with chronic venous insufficiency, a disease of the vessels that carry blood back to the heart from elsewhere in the body.

White House Press Secretary Karoline Leavitt disclosed the diagnosis during a press conference on July 17 in response to public concern raised by photographs of the president with significant swelling around his ankles and bruises on his hands.

A July 17 letter from Sean Barbabella, the president’s physician, noted that Trump, age 79, underwent several diagnostic tests, including blood work and an echocardiogram, which did not identify any signs of systemic illness or heart failure. “President Trump remains in excellent health,” Barbabella wrote.

Chronic venous insufficiency is “a very, very common thing, and for [President Trump’s] age, it’s totally understandable that he has it,” says Monara Dini, a treating physician at the University of California, San Francisco, Center for Limb Preservation.

Chronic venous insufficiency—a subset of a larger category of conditions called venous disorders—predominantly affects the legs and causes only pain rather than more serious harm or systemic issues. The condition is quite common—affecting perhaps 5 percent of U.S. adults, according to Cleveland Clinic—and the risk of developing it increases as people age.

The network of vessels that carries blood throughout the body includes two main types of tubing. Arteries carry freshly oxygenated blood away from the core of your body to the extremities, while veins carry blood back to the heart and lungs. Arteries need to withstand high pressure and only contain between 10 and 15 percent of the body’s blood at a time.

Veins are under much less pressure and therefore can have thinner walls and hold more blood. In addition, they contain one-way valves that keep blood flowing in the proper direction, back toward the internal organs. Chronic

venous insufficiency is characterized by weakened valves in leg veins, allowing blood to flow backward and pool under the force of gravity, according to Johns Hopkins Medicine. These valves leak more often as people age, Dini says.

The most common cause of chronic venous insufficiency is a blood clot that damages the valve. Symptoms of the condition predominantly affect the legs and include achiness, cramping at night, swelling and discoloration, leathery looking skin, and open sores called ulcers.

“The worst outcome of having this condition is ulcers that can develop,” Dini says. “The skin is retaining so much fluid that it can, at some point, burst and break the skin, and you develop ulcerations. It happens a lot, and that’s more devastating in the sense that it requires wound care. It can be painful and life-altering.”

Bruising of the hands is not a symptom of chronic venous insufficiency, Dini says. In his letter about Trump, Barbabella attributed this to “minor soft tissue irritation from frequent handshaking and the use of aspirin, which is taken as part of a standard cardiovascular prevention regimen.”

Chronic venous insufficiency is more likely to occur in people who are overweight or pregnant, who have had a leg injury or blood clots or who have family members who have also dealt with chronic venous insufficiency. Other risk factors can include smoking and insufficient exercise.

Typically, management of chronic venous insufficiency relies on keeping the legs elevated, increasing exercise, and reducing weight. Compression therapy, which can include the use of compression socks or pumps, can also help alleviate symptoms, Dini says. In certain cases, doctors may recommend minor surgical interventions to either repair or remove damaged tissue. Chronic venous insufficiency is a progressive condition that cannot be healed or reversed, however.

venous insufficiency is characterized by weakened valves in leg veins, allowing blood to flow backward and pool under the force of gravity, according to Johns Hopkins Medicine. These valves leak more often as people age, Dini says.

The most common cause of chronic venous insufficiency is a blood clot that damages the valve. Symptoms of the condition predominantly affect the legs and include achiness, cramping at night, swelling and discoloration, leathery looking skin, and open sores called ulcers.

“The worst outcome of having this condition is ulcers that can develop,” Dini says. “The skin is retaining so much fluid that it can, at some point, burst and break the skin, and you develop ulcerations. It happens a lot, and that’s more devastating in the sense that it requires wound care. It can be painful and life-altering.”

Bruising of the hands is not a symptom of chronic venous insufficiency, Dini says. In his letter about Trump, Barbabella attributed this to “minor soft tissue irritation from frequent handshaking and the use of aspirin, which is taken as part of a standard cardiovascular prevention regimen.”

Chronic venous insufficiency is more likely to occur in people who are overweight or pregnant, who have had a leg injury or blood clots, or who have family members who have also dealt with chronic venous insufficiency. Other risk factors can include smoking and insufficient exercise.

Typically, management of chronic venous insufficiency relies on keeping the legs elevated, increasing exercise, and reducing weight. Compression therapy, which can include the use of compression socks or pumps, can also help alleviate symptoms, Dini says. In certain cases, doctors may recommend minor surgical interventions to either repair or remove damaged tissue. Chronic venous insufficiency is a progressive condition that cannot be healed or reversed, however.

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