Vascular Conditions Flashcards
What is an enlargement <1.5 times its size called?
Ectasia
What is a pseudo-aneurysm?
Where there is a collection of blood in the TA which is continuous with the lumen
What is an Ectasia?
An enlargement <1.5 times its size
What is arteriomegaly?
Generalised enlargement of arteries
When do you treat an aneurysm?
When it gets larger or ruptures
What are the presenting features of a ruptured AAA?
Abdo Pain
Radiates to back
Hypovolaemic Shock
Syncope/LoC
What is the most common peripheral aneurysm?
Popliteal - 70%
What are the risk factors for a femoral aneurysm?
IVDU
What are the complications of a peripheral aneurysm?
Thromboembolism
What is Aortic DIssection?
Where there is spitting of the tunica media from the TI.
Causes an alternative path for blood to flow
What are the risk factors for AAA and dissection?
Male White Atherosclerotic Risks FHx CT disorders Hypertension
What is a risk factor for dissection (but not AAA)?
Bicuspid Aortic Valve
What are the symptoms of propagating Aortic Dissection?
Forwards
Renal - AKI and anuria
Anterior Spinal - paraplegia, uneven BP and pulses
Carotids - hemiplegia
What are the symptoms of propagating Aortic Dissection?
Backwards
MI
Valve disease
Presentation of an aortic dissection?
Tearing chest pain
Worse leaning back
Syncope/LoC
Shock
Types of Aortic DIssection?
Type 1 - ascending aorta
Type 2 - other (30%)
Types of Aortic Dissection?
Type 1 - ascending aorta
Type 2 - other (30%)
What are the complications of an AAA repair?
Renal failure - due to clamping (ischaemia)
- due to contrast
It can move, leak
What are the complications of an AAA repair?
Renal failure - due to clamping (ischaemia)
- due to contrast
It can move, leak
Dislodging a clot
What is the classic presentation of a Aortic Aneurysm rupture?
Pain
Hypotension
Pulsatile Mass
What are the risk factors for Acute Mesenteric Ischaemia?
AF
Valve Disease
Hypercoagulable States
Other causes: Hypovolaemic Shock
Where is the occlusion normally in AMI?
Just distal to the origin of the SMA
How does AMI present?
Acute, worsening, central colicky pain
Hypotension
Shock
Abdominal Bruit
How do you treat AMI?
ABCDE
O2
Heparin and Thrombolytics
Sepsis 6
How do you investigate AMI?
Bloods - ABG Amylase G&S Clotting Amylase
ECG (AF)
CT - oedema and arteriography
CXR (perforation and gasless abdomen)
What are the symptoms of Chronic Mesenteric Ischaemia?
Colicky, central abdo pain
After meals
Weight loss/Anorexia due to avoidance
Can pass blood in stools
Where does the problem occur in Chronic Mesenteric Ischaemia
Atleast 2 mesenteric vessels
Normally atherosclerotic
How do you treat Chronic Mesenteric Ischaemia?
Reduce Atherosclerotic Risk Factors
Stent if worried about AMI
Investigating Chronic Mesenteric Ischaemia?
CT angiogram
Bloods - atherosclerotic risk
Abdo bruit
Where is the problem in Colonic Ischaemia?
Normally at the watershed area
IMA
Symptoms of Colonic Ischaemia?
LIQ pain, colicky
Bloody diarrhoea
X Ray appearance of Colonic Ischaemia?
Diffuse thickening (oedema)
What can Colonic Ischaemia lead to?
How does it present?
How do you treat?
Gangrenous Colitis
Hypovolaemic shock and peritonitis
Rapid fluid resuscitation
Resection and stoma formation
What is Acute Limb Ischaemia?
Reduction of blood supply to a limb under 2 weeks
Why does it occur?
Usually thromboembolic
Can be due to shock, vasospasm etc
Symptoms of acute limb ischaemia?
Pale Painful Parasthesia* Perishingly Cold Paralysis* Pulseless
*Late symptoms
Appearance of acute limb ischaemia
Marble white
Mottled, reticular, blanching
Same but non-blanching (too late to save limb)
Investigating Acute Limb Ischaemia?
Bloods - ABG, Clotting, G&S
Duplex
ECG
What is compartment syndrome?
Who?
Investigations?
Symptoms?
Where there is increased pressure in a closed compartment, it restricts the blood flow to a limb and can cause ischaemia and necrosis.
Needs urgent decompressive fasciiectomy
More common in males, young, post trauma, in casts, immobile
ABGs, Myoglobin, CK, H+, K+
PAINNNNN, worse on passive movement of distal tendon
How do you treat ALI?
Embolism
Thrombotic
Irreversible
Embolectomy
Thrombolysis, PCI, Bypass Grafting
Amputation
