Vascular Flashcards
In what patient population are AAA the most common?
Older men with a smoking history
What are the signs of a AAA?
Pulsatile abdominal mass
Back pain
What diagnostic test should be ordered if you suspect a AAA?
Ultrasound
When is surgery the correct treatment for a AAA?
When the size is > 5.5 cm or it is growing very fast
If the AAA is smaller than 5.5 cm and not growing very fast, what is the treatment?
Frequent ultrasounds and observation
What is the common complaint with aortic dissection?
Tearing chest pain that radiates to the back
What will be found on physical exam with an aortic dissection?
Unequal blood pressures between arms
What will be seen on imaging with an aortic dissection?
Widened mediastinum
What diagnostic measure should be obtained for an aortic dissection?
CTA
Treatment for an ascending aortic dissection? Descending aortic dissection?
Ascending = surgery
Descending = beta blockade
Peripheral vascular disease is atherosclerosis in the lower extremities. How may it present?
LE claudication
Shiny shins
Loss of hair
If PVD is severe, what symptoms can be present?
Pain with rest
Pain changes with position of lower extremities
What test should be obtained if PVD is suspected?
Ankle-Brachial Index
– compares blood pressures between UE and LE
If the ABI is > 1.4, what should be obtained? If it is between 0.9-1?
> 1.4 = Toe-Brachial index
0.9-1 = Exercise ABI
Normal range of ABI?
1-1.4
When do you use a stent for PVD?
Lesions above the knee or small lesions
When do you use bypass for PVD?
Lesions below the knee or bigger lesions
What 2 drugs are for symptoms of PVD only?
Cilostazol
Pentoxyphylline
What can cause Acute Limb Ischemia?
Cholesterol or Afib embolus/thrombus
What are the 6 P’s of Acute Limb Ischemia?
- Pulselessness
- Pallor
- Poikilothermia (cold)
- Pain
- Paresthesias
- Paralysis
Acute Limb Ischemia presents with?
6 P’s
- Pulselessness
- Pallor
- Poikilothermia (cold)
- Pain
- Paresthesias
- Paralysis
What test can diagnose Acute Limb Ischemia?
US doppler or CTA
Treatment for Acute Limb Ischemia?
Embolectomy or Intra-arterial tPA
What often causes Aortic Stenosis? What are some presenting signs?
Calcifications
= chest pain, syncope, CHF
What murmur will be heard with Aortic Stenosis?
Systolic
= CRESCENDO-DECRESCENDO that radiates to the carotids
What often causes Mitral Regurgitation?
Infection
Rupture of papillary/chordae heart muscles
What murmur will be heard with Mitral Regurgitation?
Systolic
= Holosystolic and radiates to axilla
Where is Aortic Regurgitation heard best at?
Left 4th ICS
What murmur will be heard with Aortic Regurgitation?
Diastolic
= Descrescendo and blowing murmur
What classically causes Mitral Stenosis?
Rheumatic heart disease
What murmur will be heard with Mitral Stenosis?
Opening snap and rumbling murmur
How are these heart murmurs diagnosed?
Echo
What is the treatment for most of the heart murmurs in this deck?
Valve replacement
When you replace a heart valve with a mechanical valve, what is necessary?
Lifelong anticoagulation
Name that murmur:
1. Opening snap and rumbling
2. Decrescendo and blowing
3. Holosystolic with axilla radiation
4. Crescendo-Decrescendo with carotid radiation
- Mitral Stenosis
- Aortic Regurgitation
- Mitral Regurgitation
- Aortic Stenosis
