Chronic Venous Insufficiency: A Vein Specialist on Causes and Symptoms for Trump's Diagnosis

CNET

24-07-2025

In a July 17 memo from Dr. Sean P. Barbabella, the president's doctor, Trump was diagnosed with chronic venous insufficiency or CVI. According to Barbabella, this diagnosis is common, especially in older adults over the age of 70 (Trump is 79), and "benign." As for the bruising that has been seen on the back of Trump's hand, his doctor states that it's a separate condition caused by him frequently shaking hands while also being a benign side effect of him taking aspirin.
Though Barbabella's memo concluded that "President Trump remains in excellent health," we wanted to know more about CVI and if it's as benign as it's been made to seem. To learn more about chronic venous insufficiency's potential causes, symptoms and treatment, we reached out to Khanh Nguyen, DO, chief medical officer of the Center for Vein Restoration.
What is chronic venous insufficiency?
Chronic venous insufficiency is when your legs' veins don't work as well as they should. "Normally, veins have small valves that help keep blood flowing back up toward the heart," explains Nguyen, who is not involved in Trump's case but has treated patients for CVI. "But if those valves become weak or damaged, blood can start to pool in the legs instead of moving upward like it should."
Chronic venous insufficiency causes
The most common causes of CVI, according to Nguyen, are:
Aging : "As we get older, our veins and valves naturally weaken."
: "As we get older, our veins and valves naturally weaken." Family history : "If close family members have vein problems, you're more likely to develop them, too. Genetics play a significant role in developing venous disease."
: "If close family members have vein problems, you're more likely to develop them, too. Genetics play a significant role in developing venous disease." Being overweight : "Extra weight puts more pressure on the veins in your legs."
: "Extra weight puts more pressure on the veins in your legs." Sitting or standing for long periods : "This makes it harder for blood to move out of the legs, especially without movement. Blood is constantly fighting against gravity to return to the heart, so walking and activating the calf muscle helps the blood to be pumped back."
: "This makes it harder for blood to move out of the legs, especially without movement. Blood is constantly fighting against gravity to return to the heart, so walking and activating the calf muscle helps the blood to be pumped back." Pregnancy : "Increased blood volume and hormone changes can put a strain on the venous system. In addition, the enlarged fetus and uterus also put pressure on the abdomen and pelvis, compressing the veins and impeding blood return, further increasing venous hypertension."
: "Increased blood volume and hormone changes can put a strain on the venous system. In addition, the enlarged fetus and uterus also put pressure on the abdomen and pelvis, compressing the veins and impeding blood return, further increasing venous hypertension." Previous blood clots: "A history of deep vein thrombosis (DVT) can damage vein valves and puts a patient at higher risk for developing venous disease." DVT occurs when a blood clot forms in one or more of the body's deep veins, typically in the legs.
These various factors can cause an increase in pressure in the leg veins over time, contributing to venous insufficiency. However, Nguyen states that early treatment and lifestyle changes can help manage symptoms and prevent worsening conditions.
Chronic venous insufficiency symptoms
While CVI symptoms can vary, Nguyen lists common ones as: leg swelling, heaviness, aching, throbbing, restless legs and cramping. Many patients also notice varicose veins and skin changes like darkening or itching around the ankles. In advanced cases, you may even see venous ulcers or open wounds near the lower legs.
"Symptoms often worsen after prolonged periods of standing or sitting and improve with leg elevation and the use of compression stockings," states Nguyen.
PonyWang/Getty Images
Is chronic venous insufficiency 'benign'?
Though Dr. Sean P. Barbabella, Trump's doctor, claims CVI is "benign," Nguyen says that's not the full picture. "While CVI is often labeled 'benign' because it's not life-threatening like arterial disease, it's not a harmless condition," he says. "Left untreated, it can significantly impact quality of life and lead to complications like chronic pain, skin changes, venous ulcers and potentially blood clots."
In other words, chronic venous insufficiency isn't something you should ignore. "It's a medical issue that warrants expert attention and treatment, particularly because early intervention can help prevent its progression," Nguyen explains.
Chronic venous insufficiency diagnosis
"CVI is typically diagnosed by taking a thorough history and performing a physical examination followed by a duplex ultrasound, a noninvasive imaging test that visualizes blood flow and evaluates the function of the veins and their valves," says Nguyen. This test allows doctors to confirm venous reflux (when veins struggle to circulate blood back to the heart) and rule out other conditions like deep vein thrombosis.
Chronic venous insufficiency treatment
Nguyen reports that CVI is treated with a combination of the following: compression therapy, lifestyle changes and minimally invasive procedures that close off or redirect blood flow from malfunctioning veins.
"Today's advanced outpatient treatments typically take under an hour to complete, require little to no downtime, and are covered by insurance when medically necessary," he explains. "Patients can return to their normal routine immediately, with few restrictions."
Early CVI diagnosis and treatment are key
According to Nguyen, one of the biggest challenges with CVI is that people ignore early symptoms, writing them off as fatigue or aging. This is especially concerning because CVI is treatable, thanks to modern therapies that are effective, safe and fast.
"If you're experiencing leg discomfort, swelling or visible veins, don't wait -- early diagnosis and treatment can make a tremendous difference in your longterm leg health and comfort," concludes Nguyen.