Vascular Emergencies Flashcards
What is an aortic aneurysm?
A swollen bulge that develops in the aorta, an aneurism is classed as large once it reaches 5.5cm, this is when it is at risk of rupturing
What are the two types of aortic aneurysm?
Abdominal + thoracic
What are the nine risk factors for developing an aortic aneurysm?
- smoking
- family history of aneurysms
- high blood pressure
- diabetes
- atherosclerosis
- trauma
- Marfan syndrome
- syphilis and other infections
- congenital defects
What is aortic dissection?
When weakened wall of the aorta tears causing blood to leak through, this can happen suddenly or slowly over time
What is an aortic rupture?
When all the layers of the aorta wall tear, often due to to a large aortic aneurysm bursting
What is acute limb ischaemia?
Sudden occlusion of distal arterial perfusion (when blood is blocked from flowing from the central body to a certain limb), often due to thromboembolism
What is an AV fistula / graft haemorrhage?
Arteriovenous fistulas / grafts are types of vascular access used primarily for haemodialysis in patients with chronic kidney disease, haemorrhage from these sites can cause significant blood loss
What is an AV fistula?
A surgical connection between an artery and a vein, normally in a patients arm
What is an AV graft?
A synthetic tube or material used to connect an artery to a vein serving as a bridge
Name signs and symptoms of aortic aneurysm
- usually asymptomatic till too large / rupture
- sometimes abdominal aortic aneurysm (AAA) is detected as palpable pulsatile (can feel it pulsating) mad with bruits (abnormal turbulent blood flow through and artery)
- patients normally present with non-descript back or abdominal pain
Name signs and symptoms of aortic dissection or rupture
Sever pain, shock which presents as pale, sweaty, tachycardia, hypotension, loss of palpable pulses and reduction in consciousness, and cardiac arrest
Name the differentials of aortic aneurysm rupture / dissection
- ACS
- PE
- Muscular back pain
- other abdominal complaint
- resolved abdominal complaint
Name causes of acute limb ischaemia
- emboli from the heart e.g. AF
- proximal arterial disease and artherosclrosis
- vichrows triad of risk of thrombosis
Name risk factors of acute limb ischaemia
- old age
- peripheral artery disease
- artherosclerosis
- cardiac arrhythmias (AF)
- recent MI
- valve replacement
- recent vascular surgery
- hypertension and cholesterol
- malignancy
- smoking
- diabetes
Name the six Ps of limb ischaemia
- Pain
- Pallor ( / cyanosis / mottling)
- Pulselessness
- Perishing cold
- Paraesthesia (reduced sensation / numbness)
- Paralysis
Name differentials of acute limb ischaemia
- DVT
- stroke or transient ischemic attack (TIA)
- raynaud’s
Name causes and risk factors of AV fistulas / grafts haemorrhaging
- weakness
- infections
- trauma
- appearing altered
- non-healing wound
- prolonged bleeding
- growing aneurysms
- thin skin over site
- other skin integrity issue
