{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:02:28Z","timestamp":1764687748315,"version":"3.37.3"},"reference-count":5,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>We present the case of a 58\u2010year\u2010old man who presented to our wound care centre with a 7 \u2010month history of a progressive unilateral leg ulcer. He reported intermittent, heavy bleeding at the ulcer. The duplex sonography showed a bilateral incompetence of the saphenofemoral junctions and the entire course of the great saphenous veins and, surprisingly, also a bilateral reversed arterial\u2010like pulsating flow in the great and small saphenous veins as well as in the deep veins of the lower extremities. During cardiac examination by auscultation and echocardiography, we detected a previously undescribed severe tricuspid insufficiency with strongly reduced systolic ejection of both the left and the right ventricle and repercussions on the peripheral venous system as a cause for the pulsating veins. This case report highlights that, although infrequent, the presence of pulsating varicose veins points to the presence of cardiac abnormalities, especially severe tricuspid insufficiency, and should direct clinicians to initiate a thorough cardiological examination. Our case highlights that consequent compression therapy can be sufficient for wound healing in such cases and should be initially considered. These patients are at risk of severe bleeding, and therefore, interventions should be carefully planned.<\/jats:p>","DOI":"10.1111\/iwj.12834","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T04:08:55Z","timestamp":1510114135000},"page":"62-64","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A leg ulcer with pulsating varicose veins \u2013 from the legs to the heart"],"prefix":"10.1111","volume":"15","author":[{"given":"Sabrina Johanna","family":"Swoboda","sequence":"first","affiliation":[{"name":"Department of Dermatology Medical Center, Faculty of Medicine, University of Freiburg  Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hauke","family":"Schumann","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical Center, Faculty of Medicine, University of Freiburg  Freiburg Germany"},{"name":"Catholic University of Applied Sciences  Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2331-8981","authenticated-orcid":false,"given":"Dimitra","family":"Kiritsi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical Center, Faculty of Medicine, University of Freiburg  Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,7]]},"reference":[{"issue":"11","key":"e_1_2_5_2_1","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00105-003-0616-0","article-title":"Epidemiology of chronic venous diseases","volume":"54","author":"Pannier\u2010Fischer F","year":"2003","journal-title":"Hautarzt"},{"doi-asserted-by":"publisher","key":"e_1_2_5_3_1","DOI":"10.1053\/j.semvascsurg.2015.07.003"},{"key":"e_1_2_5_4_1","article-title":"From the veins to the heart: a rare cause of varicose veins","volume":"2015","author":"Dalla Vestra M","year":"2015","journal-title":"Case Rep Vasc Med"},{"doi-asserted-by":"publisher","key":"e_1_2_5_5_1","DOI":"10.1016\/S0140-6736(11)61578-X"},{"doi-asserted-by":"publisher","key":"e_1_2_5_6_1","DOI":"10.1016\/j.annder.2010.03.022"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fiwj.12834","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.12834","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:21:31Z","timestamp":1695572491000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.12834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,7]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/iwj.12834"],"URL":"https:\/\/doi.org\/10.1111\/iwj.12834","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"type":"print","value":"1742-4801"},{"type":"electronic","value":"1742-481X"}],"subject":[],"published":{"date-parts":[[2017,11,7]]},"assertion":[{"value":"2017-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-09-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-11-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}