Nov24 M3-Diseases of the Peripheral Vasculature Flashcards
aneurysm def
increase in vessel size by 50%
saccular true aneurysm
outpoutching of a portion
fusiform true aneurysm
symmetrical dilation
pseudoaneurysm
rupture and blood accum in adventita
aneurysm presentation
found incidentally usually.
compression of adjacent structure (recurrent laryngeal nerve, esophagus, bronchus)
**how to manage aneurysm
optimize risk factors (smoking, htn, dyslipidemia)
meds in Marfans
surgery
dissection def
blood from lumen passes through tear in intima and goes in media and spreads
acute intramural hematoma
hemorrhage in wall without intima tear (vasa vasorum)
penetrating atherosclerotic ulcer def
erosion of plaque in aortic wall .
sharp calcifications cause bleed in media
aortic rupture def
rupture of aorta bc of penetrating ats ulcer, acute hematoma, dissection (usually dissection)
most dissections where
ascending aorta
type A vs B dissection and proportion
67% type A: ascending + arch
33% type B: descending
dissection symptom
tearing sensation in the back
diagnose dissection how
CT contrast, transesophageal echo, angiography
treatment of dissection type A vs B
A and B: beta blockers and nitropusside to reduce contractility + surgery
B: meds only if uncomplicated
peripheral arterial disease main cause + risk factors
ats. same risk factors as CAD
claudication def
angina in periphery
signs of claudication
discomfort, bruit at stenosis site, cyanosis
foot ulcers how form
areas of increased pressure, areas of poor blood supply
ankle-brachial index use
to diagnose PAD. 1 or more normal. less 0.9 abnormal. less 0.5 severe
treatment of PAD
risk factors, antiplatelet anticoag, angioplasty or CABG
acute arterial occlusion def
like MI in periphery
AAO 6 symptoms
6 Ps: pain pallor paralysis parasthesia, pulselessness, poikilothermia (cold)
AAO treatment
thrombolysis + anticoag
origins of arterial emboli
cardiac, arterial and venous (if ASD)
vasculitic syndromes
immune rx to vessel wall
3 vasculitic syndromes
Takayasu arteritis (aorta and major branches) Giant cell arteritis (medium to large veins, cranial vesels thromboangiitis obliterans (inflam of small arteries) = Buerger disease
Raynaud’s phenomenon def
vasospastic disease of digital arteries: fingers turn white to blue to red in response to cold or stress
primary vs secondary Raynaud’s
primary: benign, in women
secondary, CT disease and arterial occlusive disease
Raynaud’s treatment
avoid cold
maybe CCB, alpha blocker, PDE-5 inhibitors
