PVD/ PAD Flashcards
Alterations in Cardiovascular System
Impaired arterial circulation:
- Beurger’s Disease, Raynaud’s Disease, Aneurysm’s, Embolus, Thrombus
Impaired venous circulation:
- Varicose veins, Venous ulcer’s/ Cvi, Thrombus, DVT
PAD - Peripheral Artery Disease
PVD - Peripheral Vascular Disease
Arterial Disease
- Hypertension
- Arterial thrombus/ embolism
- Beuger’s Disease
- Raynaud’s Syndrome
- Aortic aneurysms
PVD
Refers to any abnormality in the arteries or veins outside the heart
Common sites of atheromas in peripheral circulation are abdominal aorta and femoral and iliac arteries
PVD
Partial occlusion may impair both muscle activity and sensory function in legs
Total occlusion may result from thrombus obstructing lumen
- breaking off (embolus) obstructing smaller vessels
PVD
Loss of blood supply leads to:
- Necrosis
- Ulcers
- Gangrene - bacterial infection of necrotic tissue
PVD: S&S
Inc. fatigue and weakness in legs
Intermitten claudication or leg pain d/t muscle ischemia - pain subsides with rest
Sensory impairment - paresthesias; burning, tingling, numbness
PVD: S&S
Peripheral pulses - popliteal and pedal weak or absent
Skin changes on feet and legs - marked pallor or cyanosis when elevated and rubor or redness when down
- Skin dry and hairless, toenails thick and hard, feet or lower legs cold
PVD: Diagnostic Tests
Doppler studies - ultrasonography
Arteriography
Plethysmography - measures size of limbs and blood volume in organs and tissues
Beurger’s Disease (Thromboangitis Obliterans)
Inflammatory condition of med-small peripheral arteries - vascular occlusion. Formation of thrombi filled with inflammatory and immune cells, permanent occlusion and obliteration Legs and arms Genetic factors Usually young men before age 35 Cigarette smoking plays a profound role
Beurger’s Disease: S&S
Severe pain, even at rest Sluggish blood flow Rubor caused by dilated capillaries and cyanosis Thin shinny skin Thickened nails, malformed Ulceration Gangrene
Raynaud’s Syndrome
Common in young woman
Considered idiopathic (without cause)
Vasospastic condition
- Temporary vasoconstriction - arterioles (small arteries), fingers and toes, usually bilateral
Ethology - unknown, associated with systemic sclerosis, scleroderma, vascularitis, malignancy, chemotherapy, cocaine use, etc.
Exposure to cold and long term vibration
Raynaud’s Syndrome: S&S
Temporary ischemia - pallor, numbness, cyanosis - followed by vasodilation, redness and throbbing pain
Triggered by exposure to cold, stress or smoking
- Protect hands from cold
Blue-white-red disease - vasospasm causes fingers to turn blue, then white as blood flow severely limited, red when warm and spasm resolved
Raynaud’s Syndrome: Diagnostic Tests
Clinical symptoms for 2 years
Antinuclear antibody titre- autoimmune disorders
Doppler ultrasonography - reduced blood flow
Arteriography - rule out arterial occlusive disease
Aortic Aneurysms
A localized dilation of arterial walls
Most common - abdominal or thoracic aorta.. aorta very susceptible due to constant stress
- Different shapes: fusiform or dissecting
- Develops from defect in medial layer
- May eventually rupture causing massive hemorrhage
Aortic Aneurysms: Etiology
Dilation or outpouching or a vessel wall or cardiac chamber - involve the layers of the wall - a weakening of a vessel wall
- Atherosclerosis
- Trauma (esp. car accidents)
- Syphillis and other infections
- Congenital defects
Aortic Aneurysms: S&S
Frequently asymptomatic for long periods of time
Thoracic - dysphagia and dyspnea
Abdominal - sometimes detected as palpable, pulsating masses with bruits
Rupture - sometimes moderate - more often - severe bleeding and death
Signs of rupture - severe and indications of shock
Dissection - severe pain, loss of pulses, organ dysfunction
Aortic Aneurysms - Diagnostic Tests
Radiography - abd. x-ray
Ultrasound - abd.
CT scan
Diseases of the Arteries and Veins: Thrombus Formation
Blood clot that remains attached to the vessel wall
Risk factors include intimal injury/ inflammation, obstruction of flow, pooling (stasis)
Thromboembolus
Thrombophlebitis
Arterial thrombi
Venous thrombi
Diseases of the Arteries and Veins: Embolism
Bolus of matter that is circulating in the blood stream
- Dislodged thrombus
- Air bubble
- Amniotic fluid
- Aggregate of fat
- Bacteria
- Cancer cells
- Foreign substance
Diseases of the veins: Varicose Veins
A vein in which blood has pooled Distended, tortuous, and palpable veins Caused by trauma or gradual venous distention Risk factors: - Age - Female gender - Family Hx - Obesity - Pregnancy - DVT - Prior leg injury
Diseases of the Veins: Chronic Venous Insufficiency
Inadequate venous return over a long period d/t varicose veins or valvular incompetence
Venous stasis ulcers
Diseases of the Veins: DVT
Obstruction of venous flow leading to increased venous pressure
Factors:
- Triad of Virchow
- - Venous stasis
- - Venous endothelial damage
- - Hypercoagulable states
- Other (cancer, orthopaedic surgery/ trauma, heart failure, immobility)
