President Donald Trump has been diagnosed with chronic venous insufficiency (CVI), a prevalent circulatory condition that impairs leg blood circulation. Trump received the diagnosis on July 17, 2025, after he had “mild swelling in his lower legs” and went through extensive medical examination conducted by the White House medical unit. White House Press Secretary Karoline Leavitt reported in a press conference that it is a “benign and common condition, especially in people older than 70.”
Comprehensive testing was conducted on the 79-year-old president with bilateral lower extremity venous Doppler ultrasounds, diagnostic vascular examinations, and an echocardiogram. Surprisingly, there was no indication of deep vein thrombosis, artery disease, heart failure, renal function impairment, or systemic disease in the tests. Observable bruising on Trump’s hands was also contested by the White House, which attributed it to “minor soft tissue irritation from repeated handshaking and the use of aspirin” as part of his anti-cardiovascular disease regimen.
What is Chronic Venous Insufficiency
Chronic venous insufficiency happens when the veins in the legs cannot pump blood back to the heart properly. Under normal circumstances, the one-way valves inside veins in the legs keep blood from flowing backward, but when the valves are weak or have been damaged, blood will flow backward and pool in the legs. Pooling causes high pressure in the veins, and this creates the usual signs of the disease.
The condition impacts the body’s circulatory system by interfering with the usual back flow of oxygen-depleted blood from the legs to the heart. The moment the valves are no longer working properly, blood is trapped in the lower extremities, distending the veins and resulting in numerous symptoms and complications. CVI is most prevalent in adults aged above 50 years, and with rising age, the risk rises exponentially.
Symptoms and clinical manifestations
Symptoms of chronic venous insufficiency are variable in severity and worsen over time if untreated. The most typical symptoms encountered are:
- Ankle and leg swelling and edema that is visible by day’s end
- Pain, ache, and heaviness in the leg that are noticeable especially after long standing
- Sensation of calf tightness or heaviness
- Leg spasms and cramps
- Burning and itching in legs
- Visible varicose and spider veins
- Skin alterations, such as brown pigmentation around the ankles
- Restless leg syndrome, as a sense of discomfort to move the legs
In severe cases, the patients will have severe complications such as venous stasis dermatitis, lipodermatosclerosis (thickening and hardening of the skin), and refractory venous ulcers. The changes in the skin usually start at the ankle region and may very much impact quality of life.
Causes and risk factors
There are numerous potential etiologies for the onset of chronic venous insufficiency. Its most important causes are:
- Damaged valve of veins from aging, trauma, or birth defects
- Deep vein thrombosis (DVT) and resultant scarring of veins
- Secondary venous reflux due to varicose veins
- Increased leg vein pressure due to prolonged standing or sitting
Risk factors for CVI that predispose one to its occurrence are older age (specifically above 70 years), obesity, pregnancy, venous disease family history, smoking, physical inactivity, and jobs that involve standing for long durations. It is more common in women compared to men and occurs in about 10-35% of US adults.
Treatment options and management
Treatment of chronic venous insufficiency aims at the restoration of blood flow, relief of symptoms, and prevention of complications. Conservative management is the mainstay of therapy:
- Compression therapy with graduated compression stockings is the mainstay of therapy
- Lifestyle modification with frequent exercise, weight loss, and elevation of legs
- Medication with venoactive drugs may yield symptomatic relief
Minimally invasive treatments are an option in more advanced disease:
- Endovenous thermal ablation with radiofrequency or laser energy to seal off incompetent veins
- Sclerotherapy by injection of materials into scar and obliterate offending veins
- Ultrasound-guided foam sclerotherapy for the correction of insufficiency of the saphenous vein
Surgical options can be reserved for highly selected situations, such as high ligation and stripping of incompetent veins, but these are typically reserved for refractory situations. Recent advances involve experimental procedures such as the SAVVE (Surgical Antireflux Venous Valve Endoprosthesis) trial, an implantation of bioprosthetic valves to correct proper blood flow.
Prognosis and long-term outlook
The prognosis for chronic venous insufficiency is very unpredictable based on the level of severity of the disease and when treatment began. Although CVI is not often life-threatening, it has amazing implications on quality of life and may result in serious complications if untreated.
Progression of disease is of greatest concern, with evidence to indicate that around 4% of patients develop late clinical stages each year. Of CVI patients, 58% had evidence of disease progression at 13 years in the Edinburgh Vein Study. Nevertheless, initiation of treatment can markedly delay disease progression and enhance outcomes.
Quality of life effects are significant, with patients reporting decreased mobility, chronic pain, and social restriction. Research using the CIVIQ-20 quality of life questionnaire has demonstrated that patients with venous ulcers have identical quality of life scores to patients with congestive heart failure or chronic pulmonary disease.
Long-term untreated complications of CVI are chronic pain, hemorrhage, superficial thrombophlebitis, progressive skin alteration, and venous ulceration. Fixed plantar flexion and stiff ankles may cause unusual instances due to chronic alteration of the soft tissue. Increasing evidence has also implicated that CVI may be linked with worse cardiovascular risk and mortality but without any understandable mechanism.
Outcome after treatment is usually very good when performed early. Control of symptoms can be achieved with compression therapy, and less invasive procedures such as endovenous laser ablation have been found to improve symptom scores and quality of life scores considerably. Early diagnosis, appropriate selection of treatment, and regular follow-up for monitoring disease progression are the mantras for effective management.
In the instance of President Trump, who has been diagnosed with what seems to be early CVI, the outlook is usually good if managed properly. The White House has also stressed that he is still “in excellent health” and that the problem is being managed accordingly. Since the more severe complications such as deep vein thrombosis and arterial disease have already been eliminated, conservative management to avoid deterioration and to keep him active will most probably be the focus.
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