What diagnosis is indicated by augmentation upon proximal compression in a CW Doppler exam?

Augmentation upon proximal compression in a continuous wave (CW) Doppler exam is indicative of a diagnosis related to venous reflux, particularly in conditions like femoropopliteal and posterior tibial valvular insufficiency. When proximal compression is applied, it temporarily occludes the venous outflow. If the Doppler signal shows an increase in flow (augmentation) immediately after the release of compression, it suggests that there is an issue with the valves in that segment of the venous system. In a healthy system, the flow should return to baseline quickly without significant augmentation.

In the case of valvular insufficiency, the incompetent valves do not close properly, allowing blood to flow backward or remain in the lower extremity during relaxation, which contributes to increased venous pressure and can be detected by the augmentation response during the Doppler examination. This finding is crucial for diagnosing chronic venous conditions that affect the flow dynamics in the venous system, particularly related to the femoropopliteal and posterior tibial veins.

Other conditions listed, such as deep vein thrombosis or chronic venous insufficiency, do not typically present with this specific augmentation upon proximal compression in the same manner as valvular insufficiency does.