I think CVC cannot lead to heart failure primarily. So let's think its pathogenesis in skin now only. I think the pathogenesis is like this - dilation of veins and capillaries due to impaired venous drainage - reduced outflow of blood from a tissue - passive process - $\to$ local increase in venous blood volume - $\to$ local increase in venous pressure - pathological - $\to$ congested tissue, red cell stasis, accumulation of deoxygenated hemoglobin - $\to$ shortage of oxygen and built-up metabolic waste - $\to$ dusky reddish-bluish skin (cyanotic) - Causes: venous thrombosis or edema; venous compression; heart failure. **What is the right pathogenesis of chronic venous congestion in skin?**