In congestive heart failure, what occurs to peripheral veins?

In congestive heart failure (CHF), peripheral veins become distended primarily due to increased venous pressure caused by fluid accumulation and impaired heart function. In CHF, the heart's ability to pump blood is compromised, leading to decreased cardiac output. This impairment causes blood to back up in the venous system, resulting in elevated pressures in the peripheral veins.

As the left side of the heart fails to effectively circulate blood, it can lead to pressure overload in the pulmonary circulation if the left ventricle is primarily affected, or in the systemic circulation if the right ventricle is involved. This results in congestion of the veins, leading to their distension. The engorgement of veins may be particularly noticeable in the neck (jugular venous distention) and in the extremities or abdomen, depending on the severity and type of heart failure.

In contrast, constriction of peripheral veins is not characteristic of CHF; instead, relaxation and distension due to increased volume and pressure are observed. Similarly, calcification of veins does not occur as a direct consequence of heart failure but could be associated with other vascular conditions. The statement that peripheral veins remain unchanged does not account for the physiological changes related to venous pressure and blood volume dynamics in CHF