Peripheral Vascular Disease Flashcards
70% of AAA patients are ______, then present with sudden death.
asymptomatic
What is the greatest risk factor for PAD?
diabetes (4-fold)
What are the 4 major risk factors for AAA?
–Age –Gender –Smoking –Family history
Thrombophilia caused by any alteration in coagulation balance that:
• increases thrombin production • enhances platelet activation/aggregation • mediates endothelial activation/damage • and/or mediates fibrinolytic inhibition
How do aortic dissection pts typically present?
severe, tearing pain –> stroke, syncope, MI, intestinal ischemia, or renal failure, depending on the location and arteries involved
AAA denoted by diameter of _____ or ____.
> 3.0 cm; 50% increase in size relative to proximal normal segment
What are the 4 major risk factors for AAA?
–Age
–Gender
–Smoking
–Family history
At what aneurism size does the 5 year rupture rate exceed 1 in 4?
5 cm diameter
What are the signs of PAD?
- Decreased or absent pulses
- Bruits (abdominal, femoral)
- Muscle atrophy
- In severe PAD (critical leg ischemia)
– Pallor of feet with elevation
– Dependent rubor
What are the risk factors for aortic dissection?
- HTN 2. drugs (cocaine) 3. CT disorders (Marfans, Ehlers-Danlos) 4. bicuspid aortic valve 5. coarctation 6. pregnancy 7. trauma
Thrombophilia caused by any alteration in coagulation balance that:
• increases thrombin production • enhances platelet activation/aggregation • mediates endothelial activation/damage • and/or mediates fibrinolytic inhibition
How will you treat PAD with antithrombotic medication?
- aspirin/clopidogrel
What is aortic dissection?
when the vessel loses its integrity and essentially unravels
How are aortic dissections treated with meds?
- control heart rate (beta blockers) 2. control BP (nitro, ACEI, Ca++ channel blockers) 3. control pain (narcs)
What are the mechanisms of thrombophilia?
- increased thrombin production 2. enhanced platelet activation/ aggregation 3. endothelial damage 4. fibrinolytic inhibition
What are the signs of PAD?
1.decreased/absent pulses 2. bruits 3. muscle atrophy 4. severe = pallor of feet w/ elevation, dependent rubor
How do aortic dissection pts typically present?
severe, tearing pain –> stroke, syncope, MI, intestinal ischemia, or renal failure, depending on the location and arteries involved
_____% of AAA patients are asymptomatic, then present with sudden death.
70
Name 2 manifestations of venous thromboembolic disease.
- PE 2. DVT
PAD has a _____ increased risk of CV death.
6-fold
What are the signs of PAD?
1.decreased/absent pulses 2. bruits 3. muscle atrophy 4. severe = pallor of feet w/ elevation, dependent rubor
30% of pts present with _____, then die.
abdominal discomfort or severe pain radiating to the back
DX? • 68 yr old male in for routine exam • H/O revascularization for angina in 2009 • In 2011 developed symptoms of left calf cramping on walking 1 block, relieved by rest • Risk factors: 50 pack years smoking, LDL 135, and diabetes • Physical exam: – Right carotid: artery bruit – Left leg: absent femoral and pedal pulses – Right leg: normal femoral and pedal pulses
L leg claudication, probably at the level of the iliac artery
What are the risk factors for thrombophilia?
- severe inherited (homozygous protein C deficiency) 2. mild inherited (heterozygous factor V Leiden) 3. acquired (infection, inflammation, estrogens)
