Cardiovascular Conditions 4 Flashcards
What do I need to know about circulation?
There are two ‘circulations’ running in tandem
* PULMONARY – blood to the lungs to collect oxygen; right side of the heart
* SYSTEMIC – blood to the rest of the body to deliver oxygen, left side of the heart
What do I need to know about Intermittent Claudication?
This is essentially a ‘cramp’
A muscle pain caused by ischaemia (lack of blood supply and therefore oxygen) of the muscles.
What are the signs and symptoms of Intermittent Claudication?
Signs and symptoms
* Use of involved muscles causes pain, discomfort or aching
* Pain resolves quickly on rest
* Pain tends to be localised to lower limbs - calf or thigh muscles, feet, hips or buttocks (shoulder, forearm and bicep pain is less common)
What causes Intermittent Claudication?
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Peripheral arterial occlusive disease - a blocking of the peripheral artieries, caused by atherosclerosis (development of fatty plaques).
What is the pathophysiology of Intermittent Claudication?
Narrowing of one or more arteries impairs blood flow to muscle tissues within the legs and less often the arms.
Perfusion of these tissues tends to be reduced. leading to ischaemia.
What do I need to know about Raynaud’s Disease?
A severe vasospasm leading to blanching (pallor and cyanosis) of affected digits (fingers and/or toes, less often nose or ears) and pain on re-perfusion – usually triggered by cold or less commonly, stress.
What are the signs and symptoms of Raynaud’s Disease?
Signs and symptoms
* Cold fingers/toes which change from
normal hue to blueish
* Tingling and/or pain on reperfusion - usually a sudden refilling
What causes Raynaud’s Disease?
There is as yet no identified cause of Raynaud’s disease, though potential causes could include:
* Autoimmune disorder
* Cold injury - injured by cold in the past
* Occupationally induced such as vibrating machinery
* Medication induced by medicines such as beta blockers
* Blood disease or vessel disorder
* Carpal tunnel syndrome and other miscellaneous disorders
What is the pathophysiology of Raynaud’s Disease?
Pathophysiology
A potential interplay of vascular mediator (e.g. angiotensin), intravascular process (e.g. platelet activation) and neural abnormalities.
Might use rosemary (for circulation) and bilberry (for capillary integrity)
What do I need to know about Venous insufficiency?
An escape and reversal of blood flow against it’s normal pathway of travel back to the heart, often due to vein valvular incompetence and invariably in the lower limbs.
What are the signs and symptoms of Venous insufficiency? What are the potential complications or affect on wellbeing?
Signs and symptoms - start, steady out, then get worse
* Burning/throbbing pain in the calves
* Swelling of the affected area
* Cramping and aching legs
* A sensation of heaviness in the legs
* Restless legs, feel a bit twitchy
* Leg fatigue - persistent
Symptoms improve with application of cold and with walking or elevation of legs
Complications
* DVT and pulmonary embolism (PE)
* Venous ulceration and chronic poorly healing leg ulcers
* Lymphoedema - secondary swelling caused by escape of fluid
* Cellulitis
Potential impact on future wellbeing
Risks from complications are serious and will require close monitoring for good prevention –this may feel invasive and burdensome to the patient.
What causes Venous insufficiency?
Congenital valve or vessel abnormality
Damage to valves (especially from DVT)
What is the pathophysiology of Venous insufficiency?
Pathophysiology
The following factors all lead to valvular failure:
* Dilation of congenitally weak vein walls
* Incompetence of congenitally abnormal valves
* Injury to veins
* Superficial phlebitis - inflammation of blood vessels
* Hormonal influence on distensibility of valves and veins (e.g. pregnancy)
Increased pressure leads to capillary damage, which triggers to inflamatory process, which triggers oedema and scarring, and hypoxia and tissue damage.
What is convential treatment for Venous Insufficiency? How might herbs help?
Conventional treatment
* Graduated compression e.g. compression bandages
* Surgery
* Topical treatment of ulcers i.e. cleaning and dressing
Herbal approaches offer support for circulation, potential improvement of capillary integrity and promotion of tissue healing.
What do I need to know about Varicose veins?
Enlargement and twisting of veins - usually subsequent to venous insufficiency, commonly in the lower limbs.
