Vascular Emergencies 2 Flashcards
Aortic Aneurysm
What types of Aortic aneurysm are there?
- abdominal aortic aneurysm (AAA)
- Thoracic Aortic Aneurysm
Symptoms?
- Dyspnea
- feeling full up
- pain in neck, back , chest or abdomen
- pain/ difficulty swallowing
- back pain
-cough
-weak , scratchy voice
-tenderness and/or pain in chest - hoarseness in voice ( if aneurysm affects certain nerves)
Causes of Aortic Aneurysm?
- High blood pressure
- atherosclerosis
- high cholesterol
- inflammation in aorta
-sudden traumatic injury
-untreated infections such as syphillis and Salmonella.
Treatment:
-surgery
-beta-blockers
-ACE inhibitors
-Statins
-Angiotensin 2 receptor blockers (ARB’s)
What mimics Aortic Aneurysm?
- coronary Artery Disease
- gastroesopgageal reflux disease (GERD)
- Heart failure
-Peptic Ulcer
Acute Limb Ischeamia
Overview:
Sudden lack of blood flow to a limb, causing Ischeamia (lack of oxygen supply)
Cause:
- Thrombosis ( blood clot)
- Embolism (blockage of arteries)
Symptoms (six P’s):
- pain
- pallor/ cyanosis / mottled skin
- pulselessness (hard to find a pulse/ cannot find a pulse, particularly in ankles or affected limb).
- Poikilothermia (perishing with cold)
- Paraesthesia (numbness) or reduced sensations.
- Paralysis or weakness
Treatment:
- immediate Anticoagulation (anticoagulants)
Risk factors:
- diabetes mellitus
- obesity
- hypertension
- Hypercholesterolaemia (high cholesterol)
DIFFERENTIALS:
- critical limb threatining ischaemia
- acute DVT
- spinal cord or peripheral nerve compression
What can Acute Limb Ischaemia be confused with?
- Chronic Limb Ischaemia
- Atrial Fibrillation
- recent Myocardial Infarction
- Abdominal Aortic Aneurysm
- Peripheral Aneurysm
-DEEP VEIN THROMBOSIS (DVT)
AV fistula
Overview:
Irregular connection between artery and vein, causing blood flow to bypass areas of capillaries and travel directly to the vein. This means a capillaries receive less blood.
Surgical, genetic or result of an injury.
If AV fistula ruptures it can cause massive internal bleeding.
Symptoms:
- purplish , bulging veins (similar to Varicose veins)
- Oedema in arms and/or legs
- HYPOtension (low blood pressure)
- Fatigue
- Heart failure
- Cyanosis
- Clubbing of finger tips
- coughing up blood
What can AV fistula be confused with?
Varicose vein
Assessment for AV fistula?
Inspect: check for purple looking veins, check for Oedema , clubbed finger tips and cyanosis
Auscultate: listen for arms and legs, AV fistula causes a HUMMING sound.
