Non-Healing Venous Ulcer Associated With the Triple Threat of Deep Vein Reflux, Tricuspid Valve Regurgitation, and Pulmonary Hypertension

Chronic venous disease (CVD) of the lower extremities comprises a spectrum of venous disorders leading to ambulatory venous hypertension and inflammation due to obstruction, reflux, or both. Chronic venous disease is the leading cause of venous leg ulcers. This case report presents a 72-year-old man who presented with recurrent bilateral malleolar venous ulcers associated with 3 pathological processes, each contributing to ambulatory venous hypertension.Clinical ImpactThis case report suggests that numerous factors can contribute to ambulatory venous hypertension and by extension venous ulceration.