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Cardiology > Lecture 21: Diseases of Aorta/Blood Vessels > Flashcards

Lecture 21: Diseases of Aorta/Blood Vessels Flashcards

1
Q

What is the most advanced manifestation of atherosclerotic disease?

A

Atheromatous embolizaton

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2
Q

Two most common manifestations of atheromatous embolizaton

A

Livido reticularis and digital ulcers/gangerene

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3
Q

Define aortic aneurysm

A

1.5x increased diameter (>3 cm) of aorta, typically between renal arteries and bifurcation

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4
Q

Thoracic aortic aneurysm associated with…

A

Genetic diseases and valvular issues

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5
Q

Abdominal aortic aneurysm associated with…

A

Traditional CV risk factors (atherosclerosis)

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6
Q

Symptoms of aortic aneurysm (2). Can be…Dilation size for rupture risk and % survival if rupture

A

Pain, compression of adjacent structures; asymptomatic; >5 cm; 50%

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7
Q

Define aortic dissection

A

Inherent weakening of wall leads to a tear in the wall layers

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8
Q

Causes of aortic dissection

A

Genetic (Marfan’s), inflammatory arteritis, increased wall stress (drugs, trauma)

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9
Q

Types of aortic dissection

A

A: tear into ascending aorta; B: after left subclavian artery

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10
Q

Presentation of aortic aneurysm (5)

A

Acute pain, hemodynamic instability (type A), discrepant blood pressures, renal failure (if block), extremity pain/paralysis (if extends into legs)

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11
Q

Define peripheral artery disease. Prevalence? Who gets it?

A

Atherosclerosis of aorta, iliac, lower extremity arteries; >15% in >55 years of age; associated with smoking and DM

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12
Q

Two main clinical manifestations of PAD

A
  1. Intermittent claudication (pain on exertion); 2. Critical limb ischemia (most severe manifestation: pain/parasthesia at rest)
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13
Q

Do people with PAD always have symptoms?

A

Nope

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14
Q

Where do symptoms of PAD develop?

A

One segment below blockage

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15
Q

Where is the most common vessel to be blocked in PAD?

A

Femoro-popliteal

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16
Q

What level is associated with DM or kidney disease?

A

Tibial-peroneal

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17
Q

Symptoms of critical limb ischemia (5)

A

Rest pain, ischemic ulcerations, gangrene, elevation pallor, dependent rubor

18
Q

What is ABI? What is normal? Is obstruction less or more?

A

Ankle-Brachial Index = highest ankle systolic BP / highest brachial systolic BP; normal = 0.9 - 1.4, obstruction decreases ratio (

19
Q

Describe changing arterial pulse volume waveforms with increasing disease

A

Loss of dichrotic notch –> flattened peak, parvus and tardus –> severely flattened

20
Q

How can you find the level of the PAD?

A

Measure blood pressure along leg and find where drop occurs (segmental pressure)

21
Q

Can you use imaging to detect PAD?

A

Yes! MR and CT

22
Q

How do we decrease cardiac events and death with PAD? (lifestyle changes and meds = 5)

A

Stop smoking, control BP, control lipids, antiplatelet therapy, exercise, control diabetes

23
Q

How do we improve symptoms of PAD?

A

Walking program (walk to pain –> rest), pharma therapy (cilostazol), revascularization

24
Q

Reasons for acute arterial occlusion (6)

A
  1. In-situ thrombosis, 2. Embolism, 3. Arterial trauma, 4. Vasculitis, 5. Hypercoagulable, 6. Severe venous thrombosis
25
Q

Symptoms of acute limb ischemia and mnemonic

A

6 P’s: pulseless, pain, paralysis, parasthesia, pallor, poikilothermia

26
Q

ALI management

A

Depends on extent of damage to tissue (from no immediate threat –> amputation)

27
Q

What is Buerger’s Disease: definition, symptoms, patients who get it

A

Segmental inflammation of medium-sized arteries and veins involving two or more limbs; TRIAD: superficial thrombophlebitis, Raynaud’s, distal arterial occlusion; associated with older men and tobacco use (essential)

28
Q

Raynaud’s: stage 1

A

Pallor

29
Q

Raynaud’s: stage 2

A

Cyanosis

30
Q

Raynaud’s: stage 3

A

Rubor

31
Q

What brings on Reynaud’s?

A

Cold exposure, emotional triggers

32
Q

Primary Raynaud’s…

A

Bilateral, 2 years, without cause, young females, doesn’t worsen

33
Q

Virchow’s triad

A

Stasis, vessel wall injury, hypercoaguability = thrombosis

34
Q

Symptoms of venous thrombosis (4)

A

Leg pain, swelling, erythema, palpable cord

35
Q

What is Phlegmasia Cerulea Dolans?

A

Turgid, blue, painful leg –> life and limb threatening emergency

36
Q

What is chronic venous insufficiency?

A

Incompetent valves that do not allow for normal venous return to heart

37
Q

More likely to get a PE with what kinda veins?

A

Proximal DEEP veins over distal MUSCULAR veins

38
Q

Symptoms of PE (5)

A

SOB, chest pain, hemoptysis, tachycardia, hypoxia

39
Q

What does a massive PE cause?

A

RV strain

40
Q

Treatment of chronic venous insufficiency. This could prevent what complication?

A

Compression stockings (to MAINTAIN edema control); lipodermatosclerosis

Cardiology (22 decks)

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