Trump diagnosed with chronic venous insufficiency following leg swelling

Trump diagnosed with chronic venous insufficiency following leg swelling

We’ve been listening to the white House press briefing there hit a number of topics, most notably, or among the notable topics we heard about the president’s, medical condition, with the white House press secretary there saying that he was evaluated, by the white House medical unit after questions and after the president noticed, some swelling in his legs. And they said, in an effort of transparency, that they that tests were performed. I want you to just listen to the sound here. Speculating about, bruising on the president’s hand and also swelling in the president’s legs. So in the effort of transparency, the president wanted me to share a note from his physician with all of you today. In recent weeks, President Trump noted mild swelling in his lower legs, in keeping with routine medical care and out of an abundance of caution. This concern was thoroughly evaluated by the white House Medical Unit. The president underwent a comprehensive examination including diagnostic vascular studies, bilateral lower extremity vent that venous Doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition, particularly in individuals over the age of 70. Importantly, there was no evidence of deep vein thrombosis or arterial disease. Laboratory testing included a complete blood count, comprehensive metabolic panel coagulation profile, D-dimer, the type Natrium peptide, and cardiac biomarkers. All results were within normal limits. An echocardiogram was also performed and confirmed. Normal cardiac structure and function. No signs of heart failure. Renal impairment, or systemic illness were identified. Additionally, recent photos of the president have shown minor bruising on the back of his hand. This is consistent with minor soft tissue irritation from frequent handshaking and the use of aspirin, which is taken as part of a standard cardiovascular prevention regimen. This is a well known and benign side effect of aspirin therapy, and the president remains in excellent health, which I thank all of you witness on a daily basis here. All right. Let’s bring in emergency physician doctor Jeremy Fowles to talk a little bit about what we’re hearing there. doctor, take us through this because it’s really two things that we’re hearing. Chronic venous insufficiency a benign I think I heard her say when it came to the swollen ankles that have been observed. And then also, she’s seeing bruising on the back of the hand, due to, aspirin regimen combined with a lot of handshaking. take us through this. Thanks. Yeah. Thanks for having me. first thing, I think that we’re just hearing a lot of medical jargon such that even you’re just mentioning a benign. I think you’re hearing her just saying a benign condition. A benign condition is what is for benign condition. Which is. Which is great, right? but it’s always good to unpack all of these terms. So what happened here was good medical care so far. And it’s basically not alarming information. And it’s not surprising. The president is an older man. I believe he just turned 79 years old. He has had risk factors for, this condition that they’re talking about, which is called chronic venous insufficiency. And what that really means is that the blood that goes out of the heart, has to return to the heart through the veins. And as we age, some of that blood flow back to the heart. That’s called venous return, just slows down in some patients more than others. And that can lead to things like swelling that can lead to that can look like things that many people would be familiar with, like varicose veins. So this is a pretty normal part of aging, and especially for someone in the overweight to obese category, which is where the president has always been. And, but the bigger concern which was addressed in that information that we just heard about is, is that symptoms like this do need to be evaluated for more serious conditions, and that is what happened. And I want to bring in cardiologist doctor Bernard Ashby as well to this conversation because, to Doctor Phelps point, as the press secretary laid out, there is no evidence of deep vein thrombosis or arterial disease. And what they laid out even with this diagnosis of chronic venous insufficiency. Can you just can you just break down what the concern may have been or would have been if there was deep vein thrombosis, and why the need to make that distinction was necessary. we might be having some, some audio issues. but Doctor Foust can can, if you’re still on the line, I can I just pose that same question, to you, just about the deep vein thrombosis and and why that distinction is necessary? Yeah. This is the important thing. When people have symptoms, they want to get looked at to find out if there’s a danger or whether it’s a relatively less dangerous, benign condition that’s just causing some discomfort. And as stated, a deep vein thrombosis is what the concern would be. That is an abnormal blood clot. We are always our blood is always on this balance between, how thick and thin it should be. And we have an amazing we have amazing bodies that keep, our blood in a really narrow range of how thin or thick it should be for our own safety. To thin. You bleed too much. Too thick. You make clots, which blocks off the blood supply to vital organs. And so when you have if you’re if your blood is a little too thick or a little too slow in terms of getting back to the heart, which is this condition that the president does have, these blood clots can start to accumulate in places where they’re not supposed to or get too large to be safe. And the concern there would be when that blood clot occurs, that it can actually then break off of the vessel where it where it’s forming, usually in the legs, and travel up back to the heart. And then when it gets pumped back out, it can cut off blood supply chiefly to the lungs, but it can also go other places depending on individual’s anatomy and abnormalities. But these, these, these dangerous blood clots, they can be very dangerous. Some people can get these conditions diagnosed. They’re called pulmonary embolisms in their lungs, blood clots on the lungs. And they can be benign and they can be treated. but some of them can be life threatening. So it’s it’s an amazing spectrum of illness that we diagnose in doctors where people have these blood clots and the treatment can, can really vary from blood thinners by mouth or IV. But in serious, life threatening cases, some of these blood clots need to be removed actually in in medical procedures. Or we need to give, medications that break those clots apart. So it’s a it’s a spectrum of disease that can go from mild to Life-Threatening. And that is why the president was evaluated to see if he had that condition, a blood clot. And fortunately, he did not. Yeah, really good contacts there. And, Doctor Ashby, as you’re listening to what we’re hearing from the white House here, they’re describing this as benign, right, as something that isn’t harmful to the president at this point in time. But let’s take a look at his lifestyle, because he obviously has a very demanding travel schedule at times. we know that that can certainly cause risk factors to circulation. there is his age. There is his history of certainly he does play a quite a lot of golf, but he doesn’t have a history of really intensive cardiovascular activity. How do all of these things, work together and what kind of treatment, or management might a doctor be looking at over time for someone of this age who is traveling a lot and sitting a lot. Yeah. So it appears that the white House physicians were also concerned about more more than meets the eye, meaning that they did a number of tests that I overheard you say, or the, at it say earlier he had a echocardiogram, a BMP, which is a brain patriotic peptide, and lower extremity ultrasounds. So essentially they were covering all their bases, meaning that they were screening him for heart failure, which is a common cause of lower extremity swelling. In addition to that, they were concerned with, increased pressure in his heart. So they did an echocardiogram and a BMP. And if those were abnormal and you would be concerned with heart failure. So looking at the president’s extremities or his legs, he had bilateral swelling. So it’s less likely that’s related to a clot in the vein and more likely related to, things like heart failure, kidney failure, which are things that you alluded to and said that that was not the case. Now, not taking a step back, looking at the entire case. The president is obese. He is he is older and I don’t know if he has hypertension, but that’s very likely or very common in his age group, particularly with the body habitus. So when you do have a condition like lower extremity swelling, bilateral and a diagnosis venous insufficiency, the question is is it intrinsic to the veins. Meaning does the venous insufficiency that he has is it related to bad valves or is it relates to increased pressure coming from the heart. And those can be related to things like weight. Also things like sleep apnea, which he fits the kind of the the prerequisite for meaning that he has a he’s a big guy, he’s obese and more likely to have sleep apnea, which is a condition where you stop breathing at night. And that can also increase the pressure in the lungs, which can then cause a backflow to the body. And it can be seen as low extremity swelling or what you saw in the picture. So, again, even though he’s diagnosed with a benign condition. But, venous insufficiency by itself doesn’t necessarily mean it’s benign. The question is what’s causing the beans insufficiency. And so I would want to know whether or not he has any the evidence of, again, increased pressures in the heart or increased pressures in the lungs, which can be contributing to that. And if so, what what is the what is the primary cause of that? Is a sleep apnea is heart failure. But, again, this is all speculation, but I wouldn’t take the benign, the benign diagnosis on his face. I would want to work him up a little bit more to figure out exactly why he has been insufficiency. And the white House said they would send through some more details from from what was announced in the press conference. So, what? We’ll look for a lot of the, details that you just, gave us a good heads up to look for that. So you bring in a cardiologist, Doctor Ashby and Doctor Foust. thank you both for being with us.

President Donald Trump was examined for swelling in his legs and has been diagnosed with chronic venous insufficiency, the White House announced Thursday. Trump, 79, underwent a “comprehensive examination, including diagnostic vascular studies” with the White House Medical Unit, press secretary Karoline Leavitt said, reading from a note from the president’s physician, Capt. Sean Barbabella. #CNN #News