Vascular Disorders Flashcards
Risk Factors for all Vascular Disorders
older age hypertension high lipid and cholesterol diet CAD DM
General TX for Vascular Disorders
reducing risk factors dieting exercise antiplatelet pentoxifyllines and other blood thinners fish oil gingko biloba
Sacroidosis
chronic multisystem granulomatous disease of unknown cause that impacts the lungs primarily
can travel to lymph nodes, liver, kidneys, skin, eyes, and heart
Pulmonary Edema
abnormal life threatening accumulation of fluid in the alveoli and interstitial spaces that can be caused by fluid, over hydration, hypoalbuminemia, altered cap permeability, hypoxia, near drowning, malignancies of lymph system and resp distress
Pulmonary Embolisms (PE)
blockage of pulmonary arteries by a thrombus, fat, air, or tumor that can travel through the vessels and becomes lodged in the lungs
CM of PE
typically only dyspena, chest pain and hemoptysis
mild to moderate hypoxia
low O2 sat
pallor
hypotension
ECG changes for tachy and R ventricle strain
productive cough with bloody sputum
crackles on auscultation of the chest
fever
accentuation of the pulmonic heart sounds
sudden changes in LOC
Etiology of PE
DVT in legs VTE lethal are from femoral or iliac veins that traveled fat or air emboli bacterial vegetations amniotic fluid tumors
Risk Factors for PEm
sedientary lifestyle smoking recent surgery malignancy obesity oral contraceptives and hormone therapy prolonged air travel HF pregnancy clotting disorders
Tx of PE
O2 and intubation fibrinolytic agent un-fractioned heparin IV limited activity monitoring aPTT and INR levels opioids for pain inferior vena cava filter pulmonary embolectomy
Complications of PE
pulmonary infarction
pulmonary hypertension
alveolar necrosis
hemorrhage
Critical Limb Ischemia
a tx that is revascularization through surgery or endovascular procedure and conservation management
Phlebitis
inflammation, redness, tenderness, warmth, and mild edema of a superficial vein
Venous Thromboembolism
thrombus forms in association with inflammation of a vein, most common disorder of the veins that can be superficial or DVT
VTE CM
lower extremity pain edema tenderness with palpitation dilated superficial veins sense of fullness in the thigh or calf paresthesia warm skin erythema fever \+ve Homan's sign
Post-Thrombotic Syndrome PTS
occurs with 20-50% with VTE from chronic hypertension caused by valvular destruction, stiffness, and compliance of vein walls
PTS CM
pain aching heaviness swelling and tingling eczema pigmented skin secondary varicosities lipodermatolsclerosis
DVT Deep Vein Thrombosis
thrombus in the deeper veins like iliac or femoral t
Pathophys DVT
localized platelet aggregation of fibrin entrap EBC, WBC, and more blood forms it to be bigger
partial blockage causes endothelial cells cover the thrombus and stops thrombotic process
can detach and result in emboli that flows through the venous circulation to the heart and pulmonary vessels
Etiology of DVT
Virchow’s Triad is venous stasis, damage to the endothelium and hypercoagulability of the blood
CM of DVT
Palpable, firm, or subcutaneous cord like vein tenderness rubor warmth pain inflammation and induration along the vein edema febrile milk leukocytosis infections related to IV
Risk Factors of DVT
increased age pregnancy obesity malignancy thrombophilia estrogen therapy recent travel, and sclerotherapy history of chronic venous inefficiency, STV, or VTE
Diagnostics
US ACT aPTT INR Hbg Hct platelet count venous ultrasonography CTV R venography contrast venography
TX DVT
compression socks promoting activity antiplatelet therapy- vit K, warfarin and heparin revascularization therapy venous thrombectomy vena cava interruption devices catheter for clot clot busters skin care monitoring bloodwork and for sites of bleeding fall risk assessment and prevention pressure to venipuncture sites
Peripheral Artery Disease
Thickening of the artery walls is also progressive narrowing of arteries in the upper and lower extremities that can cause more complications
under recognized which can lead to limb loss
Risk Factors for PAD
tobacco DM Hyperlipidemia hypertriglyceridemia elevated C reactive protein levels uncontrolled hypertension sedentary life Hyperhomocysteinemia hyperuricemia obesity family history increasing age stress black or Hispanic history of vascular disease, MI or stroke
CM of PAD
leg pain paresthesia intermittent claudication appearance of limb be funky edema with pitting pedal pulses diminished or gone rest pain ulceration gangrene necrotic tissues cold skin erectile dysfunction dependent rubor thin, shiny skin muscle atrophy no or delayed cap refil
TX of PAD
proper screening and early detection is vital proper nail and feet care proper footwear exercise antiplatelet statins for lipids wound care and aseptic techniques revascularization surgery or endovascular procedure for conservation management protecting extremity from trauma peripheral artery bypass graph enterectomy patch graph angioplasty amputation
