Medical Tests & Procedures Archive

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A minimally invasive treatment for treating varicose veins is as effective as surgery to remove the faulty veins, according to a new study.

Most varicose veins — gnarled, bluish veins just under the skin's surface — result from problems with the great saphenous vein, the large vein located near the inside of the leg that runs from the ankle to the upper thigh. The surrounding muscles and one-way valves in the vein weaken, a condition called venous insufficiency.

In addition to a prompt assessment and potentially lifesaving treatment, expect a COVID-19 test and extra safety precautions.

Even before the pandemic, people with heart attack symptoms sometimes hesitated to seek emergency care. But during the first wave of COVID-19 infections in early 2020, many more people than usual stayed away. From mid-March to late May 2020, emergency room visits for heart attacks fell by 23% compared with the preceding 10 weeks. And 20% fewer people showed up with strokes, according to the CDC.

Fear of leaving home and risking exposure to the coronavirus likely explains this trend, which has abated over time. "The overall volume at emergency rooms is still somewhat below normal, and we're seeing people who come in many hours or even a day after their heart attack symptoms began," says Dr. Joshua Kosowsky, assistant professor of emergency medicine at Harvard Medical School. These people sometimes have signs of heart damage that might have been easier to reverse or treat if they had come in right away, he adds.

Think of inflammation as the body's natural response to protect itself against harm. There are two types: acute and chronic. You're probably more familiar with the acute type, which occurs when you bang your knee or cut your finger. Your immune system dispatches an army of white blood cells to surround and protect the area, creating visible redness and swelling. The process works similarly if you have an infection like the flu or pneumonia. So in these settings, inflammation is essential—without it, injuries could fester and simple infections could be deadly.

Chronic inflammation

But chronic inflammation can also occur in response to other unwanted substances in the body, such as toxins from cigarette smoke or an excess of fat cells (especially fat in the belly area). Inside arteries, inflammation helps kick off atherosclerosis—the buildup of fatty, cholesterol-rich plaque. Your body perceives this plaque as abnormal and foreign, so it attempts to wall off the plaque from the flowing blood. But if that wall breaks down, the plaque may rupture. The contents then mingle with blood, forming a clot that blocks blood flow. These clots are responsible for the majority of heart attacks and most strokes.

Although no longer routine, this test is still a common, safe way to assess people with heart disease symptoms.

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That chest discomfort you felt during your evening walk disappeared once you got back home. But a week later, you're carrying a laundry basket upstairs and the pain returns, although only briefly. It's time to call your doctor to discuss these symptoms — and possibly undergo an evaluation for coronary disease.

One test you may need is an exercise stress test, also called a treadmill test. As recently as a decade or so ago, doctors ordered these tests as part of a routine check-up in middle-aged and older men, regardless of their symptoms. Today, they're done mainly in people with symptoms that suggest heart disease, says Dr. Hicham Skali, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. "In general, that means stable angina, which refers to chest pain that occurs in predictable patterns during exercise or other exertion," he says. Angina occurs when the heart muscle isn't getting enough blood, which is more likely during physical activity.