Varicose veins of the lower extremity secondary to tricuspid regurgitation

Pulsating varicose veins are a rare clinical finding and are mainly derived from tricuspid regurgitation or right heart failure. The precise causes and optimal treatment of this phenomenon have been poorly recorded in the literature. Here, we describe a 56-year-old woman who presented to our medical center with bilateral varicose veins, heaviness, and edema in her lower limbs. The duplex revealed an arterial-like pulsating flow in the superficial and deep veins of the lower extremities, in addition to severe tricuspid regurgitation. Symptoms improved after the patient was given compression therapy using elastic stockings. In this article, we also review six other cases from the literature and discuss the therapies that would be reasonable in some conditions.