Vascular Pathologies Flashcards
Aneurysm Etiology
congenital defect, weakness in wall of vessel often due to chronic hypertension, connective tissue disease (Marfan Syndrome), trauma, infection
Aneurysm Signs/Symptoms
**Varies based on site
Aortic = asymptomatic except for generalized abdominal/low back pain
Abdomina Aortic= pulsing in/near navel
Cerebral= sudden/severe headache, nausea & vomitting, stiff neck, seizure, loss of consciousness, double vision
Aneurysm Treatment
Antihypertensive meds for hyptertension
Surgery to repair aortic aneurysm- break in vessel wall is replaced with synthetic fabric graft
Angina Pectoris: Stable
Occurs @ predictable level of exertion/exercise/stress, responds to rest/nitroglycerin
Angina Pectoris: Unstable
usually more intense, lasts longer, precipitated by less exertion, occurs spontaneously @ rest, is progressive, or combo of above features
Angina Pectoris: Prinzemental (variable)
occurs due to coronary artery spasm associatedw/ Coronary Artery Disease (CAD)
Angina Pectoris Etiology
inadequate blood floe and oxygenation of heart muscles due to CAD
Angina Pectoris Signs/Symptoms
pressure/ heaviness/ fullness/ squeezing/ burning/aching behind sternum (also felt in neck & back, jaw, shoulders, arms)
difficulty breathing, nausea & vomiting, sweating, anxiety/ fear
triggered by exertion/ strong emotion
subsides w/ rest
Angina Pectoris Treatment
Acute: supplemental O2, notroglycerin, rest
Chronic/ Recurring: long-acting nitrates, beta blockers, calcium channel blockers
Angioplasty w/ stenting of coronary arteries/ coronary artery bypass surgery when meds not effective
Atherosclerosis Etiology
exact cause unknown
may begin w/ damage/injury to inner artery wall from hypertension, high cholesterol, smoking, diabetes
over time fatty plaques and other cell waste build up at site of injury & harden narrowing artery and impeding blood flow
Atherosclerosis Signs/Symptoms
** varies based on severity and artery affected
Coronary arteries: angina pectoris
Cerebral arteries: numbness/ weakness in arms/ legs, difficulty speaking/ slurred speech, drooping face muscles
Peripheral arteries: intermittent claudication
Atherosclerosis Treatment
lifestyle changes: quit smoking, regular exercise, healthy diet, stress management
meds: antihypertensive, anti-platelet, anti-lipidemic agents
surgery: angioplasty, endarterectomy, bypass
Chronic Venous Insufficiency (CVI) Etiology
weak/ damaged valves in veins
Risk factors: age, being female, obesity, pregnancy, prolonged sitting/standing
CVI Signs/Symptoms
leg swelling, varicose veins, aching, heaviness/cramping, itchiness, redness/ skin ulcers of legs/ankles
CVI Treatment
compression stockings + elevation of legs to decrease chronic swelling
varicose vein stripping for persistent leg pain/ skin ulcers due to poor circulation
Cor Pulmonale Etiology (pulmonary artery disease)
pulmonary hypertension form chronically increased resistance in pulmonary circulation
Cor Pulmonale Signs/Symptoms
progressive shortness of breath especially w/ exertion
also fatigue, palpitations, atypical chest pain, swelling in LE, dizziness and syncope
Cor Pulmonale Treatment
supplemental O2 sufficient to maintain SaO2> 90% and/or PAO2> 60 mmHg
may also include diuretics & anticoagulants
Coronary Artery Disease (CAD) Etiology
damage/injury to inner layer of coronary artery
fatty plaques and other cell wastes accumulate @ site of injury
if plaque ruptures, platelets clump to repair artery- which may create blockage = heart attack
Risks: high LDL cholesteral, type 2 DBM, smoking, obesity, physical inactivity, genetics, hypertension, hypothyroidism
CAD Signs/Symptoms
degree of stenosis that produces S/S varies w/ O2 demand
diminished blood flow may = angina, shortness of breath, etc. which may not be felt till >70% of lumen occluded
complete blockage = heart attack
CAD Treatment
Aggressive modification of risk factors = slow progression/ induce regression of existing plaques/restore/improve blood flow
includes: quit smoking, weight loss, heart-healthy diet (low sat. fats/ cholest./ Na), regular exercise, modification of serum lipids, control of hypertension/diabetes
Drugs: antiplatelet, ACE inhibitors, angiotensin II bockers, statins
Surgery: percutaneous angioplasty/ coronary artery bypass graft only for pts at high mortality risk
Deep Vein Thrombosis (DVT) Etiology
any condition impairing normal circulation/ blood clotting
Risks: prolonged bed rest, inherited blood clotting disorder, injury/surgery of veins, pregnancy, cancer, birth control/ hormone replacement therapy, overweight, obesity, smoking
DVT Signs/Symptoms
about 50% of cases are asymptomatic
may show swelling, pain, redness, warmth in affected leg
DVT Treatment
GOAL: prevent blood clot from getting bigger/ breaking loose & causing pulmonary embolism
Meds: anticoagulants, thrombolytics
Prevent: compression stockings to reduce blood pooling in LE
(Congestive) Heart Failure (CHF) Etiology
coronary artery disease (CAD), hypertension, diabetes mellitus, myocardial infarction, abnormal heart valves, cardiomyelopathy
CHF Signs/Symptoms
shortness of breath, fatigue/weakness, swelling in legs/feet/abdomen, rapid/irregular heartbeat, persistent cough/wheezing, weight gain from fluid retention
CHF Treatment
1) Treat underlying cause (repair damaged heart valve/ control abnormal rhythm)
2) balance meds, devices, and lifestyle changes to help heart contract normally
lifestyle changes: quit smoking, restrict Na intake, maintain healthy weight, limit alcohol/fluids, stress reduction, moderate exercise
meds= anticoagulants, antihypertensives, digitalis (increase strength of contraction)
3) SEVERE: surgery + medical devices
Hypertension Etiology
Primary (essential) = no known cause
Secondary = usually due to renal disease
Hypertension Signs/Symptoms
often asymptomatic until organ complications develop
Severe: (DBP> 120 mmHg) = CNS symptoms (confusion, cortical blindness, hemiparesis, seizures), cardiovascular symptoms (chest pain, dyspnea) and renal involvement
Hypertension Treatment
Lifestyle Changes: aerobic physical activity 30 min/day, BMI of 18.5-24.9, quit smoking, reduced Na/alcohol intake, diet of increased fruits/ veggies/ low-fat dairy
Meds: diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin II blockers, direct vasoldilators
Hypertension Classifications:
Normal BP:
Myocardial Infarction (aka Heart attack) Etiology
ruptured atherosclerotic plaque, blood clot blocks flow through coronary artery
uncommon = coronary artery spasm
Myocardial Infarction Signs/Symptoms
chest discomfort w/ pressure, squeezing/pain, shortness of breath, UE discomfort (arms, shoulder, neck/back), nausea, vomiting, dizziness, sweating, and palpitations
Myocardial Infarction Treatment
varies from meds - surgery-both depending on severity/ amount of heart damage
Meds: to treat acute MI = anitcoagulants, thrombolytics, pain relievers, antihypertensives, cholesterol-lowering meds
Peripheral Artery Disease Etiology
primary = atherosclerosis, thromboembolic processes alter structure/function of aorta and its branches
Peripheral Artery Disease Signs/Symptoms
fatigue, aching, numbness, pain in buttock/ thigh/ calf/ foot @ rest/when walking, poorly healing wounds of legs/feet, distal hair loss, trophic changes, hypertrophic nails
Peripheral Artery Disease Treatment
for asymptomatic patients- quit smoking, lipid-lowering meds, control of diabetes/ hypertension
for pts w/ disabling intermittent claudication- revascularizing procedures (angioplasty/ stent/ lasers/ atherectomy), surgery
supervised exercise training 30-45 min 3xs/week for 12 wks
Valvular Heart Disease Etiology
congenital defect, calcific degeneration, infective endocarditis, CAD, myocardial infarction, rheumatic fever
`Valvular Heart Disease Signs and Symptoms
varies based on type/severity of valve disease- may include heart palpitation, shortness of breath, chest pain, coughing, ankle swelling and fatigue
Valvular Heart Disease Treatment
Minimal Symptoms: may not require treatment
Moderate: meds to reduce heart workload/ regulate heart rhythm/ prevent clotting (digitalis, beta blockers, calcium channel blockers)
Severe: balloon valvulplasty/ surgery to repair/replace affected valve
