What is chronic venous insufficiency; how serious is Trump's condition?

Al Jazeera

18-07-2025

United States President Donald Trump has been diagnosed with chronic venous insufficiency (CVI) after undergoing evaluation for lower leg swelling and hand bruising, the White House has announced.
Press Secretary Karoline Leavitt said on Thursday that the diagnosis was made after the president experienced mild discomfort in his legs over several weeks.
In a publicly released letter, President Trump's physician, Dr Sean Barbabella, confirmed there was no evidence of deep vein thrombosis or arterial disease. All of Trump's lab results were within normal limits.
'An echocardiogram was also performed, and confirmed normal cardiac structure and function,' the letter added.
But what is chronic venous insufficiency, and how risky is it? Here is what we know:
What is chronic venous insufficiency?
CVI is a type of vein disorder that develops when the veins in the legs become damaged, Cleveland Clinic explains. Veins have valves that help blood move up towards the heart. When these valves are damaged, they don't close properly, and blood can flow backwards. This is called venous reflux.
This can lead to blood pooling in the lower legs. Along with swelling – most often around the feet and ankles – symptoms may include aching legs, a heavy or tingling sensation, and the appearance of varicose veins.
According to Cleveland Clinic, the disease affects about one in three adults, while CVI affects people over age 50. The risk rises with age.
What are other common symptoms?
According to the American Heart Association, some symptoms include leg swelling, as the president has experienced, but also skin irritation.
The skin issues typically show up as red, itchy or flaky patches on the lower legs, caused by poor blood flow and sometimes leading to ulcers.
Additional symptoms may include pain, itching, bleeding, a heavy or tired feeling in the legs, cramping, throbbing and restlessness.
Trump also had bruising on his hand, according to the White House. Dr Barbabella attributed that to 'minor soft tissue irritation from frequent handshaking and the use of aspirin, which is taken as part of a standard cardiovascular prevention regime', the White House release stated.
How serious is CVI?
The condition is generally mild but can worsen over time.
'Chronic Venous Insufficiency can significantly impact your quality of life, but early detection and treatment can make a substantial difference,' the chair of the American Heart Association's Vascular Health Advisory Committee and Scientific Council on Peripheral Vascular Disease, Joshua A Beckman, said.
While the condition itself is usually not serious, it can be associated with more dangerous complications, such as deep vein thrombosis (a blood clot in a deep vein) or pulmonary embolism (a clot that blocks blood flow to the lungs).
Dr Barbabella, the president's physician, described Trump's case as 'a benign and common condition, particularly in individuals over 70'. He confirmed that Trump, 79, showed no signs of those more serious complications.
What is the treatment for CVI?
Doctors typically begin treatment with compression therapy, which helps reduce leg swelling and discomfort. Compression stockings are often prescribed and may be worn long-term, as they support vein function by promoting blood flow back to the heart.
In addition, doctors may recommend weight loss or resistance exercises to improve circulation.
If symptoms – such as leg pain, skin sores or thickened, hardened skin – persist, more invasive treatments may be necessary. These include thermal therapies like laser treatment, which seal off damaged veins, and sclerotherapy, whereby a chemical is injected to collapse affected veins. After treatment, the body naturally redirects blood flow through healthier veins.