Hello! Thank you for asking on HCM! I carefully passed through your question and would explain that the bulging veins could be related to increased central venous pressure. Indeed, there is not any relation between his symptoms and the bulging veins. Anyway, it is important performing a comprehensive differential diagnosis between different causes that may lead to this clinical scenario: - a metabolic disorder like thyroid dyfunction, adrenal gland dysfunction, vitamin B12 deficiency, vitamin D deficiency, an electrolyte disorder - a chronic infection or inflammatory disorder - heart failure - a cervical disc disorder could lead to numbness in the limbs and gait problems, but would not explain the changes in vein visibility. So, I would recommend consulting with his attending physician and performing some tests to investigate for the possible causes: - a chest X ray study - a resting ECG and cardiac ultrasound - some blood lab tests (complete blood count, PCR, sedimentation rate, blood electrolytes, kidney and liver function tests, thyroid hormone plasma levels, cortisol plasma levels, vitamin D and vitamin B12 plasma levels, fasting glucose) If all the above tests result normal, I would recommend consulting with a neurologist for a careful physical exam. A cervical spine MRI may be needed in case of abnormal neurological examination. Hope to have been helpful! Kind regards, Dr. Aida