1 / 24

Diseases of Arteries and Veins

Diseases of Arteries and Veins. Atherosclerosis Hypertension CAD: Stable and Unstable angina Dyslipidemia DVT, PE Clotting Medications Review. Hypertension. Primary Secondary Isolated Systolic hypertension (aortic sclerosis in elderly) Postural (orthostatic) Malignant (DBP > 120)

fayola
Download Presentation

Diseases of Arteries and Veins

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Diseases of Arteries and Veins • Atherosclerosis • Hypertension • CAD: Stable and Unstable angina • Dyslipidemia • DVT, PE • Clotting Medications Review

  2. Hypertension • Primary • Secondary • Isolated Systolic hypertension (aortic sclerosis in elderly) • Postural (orthostatic) • Malignant (DBP > 120) • Causes encephalopathy • Associated with general anesthesia

  3. Drugs Alpha-1 blockers Beta blockers ACE inhibitors ARBs Calcium channel blockers Diuretics Other Hypertension • Pathophysiology • Vasoconstriction • Increased contract • Increased HR • Increased volume • Arterial & Heart remodeling • RAAS activation

  4. Embolus • Thromboembolism • Air Embolism (diving, trauma, injection) • Amniotic • Bacterial Embolism • Fat embolism • Foreign matter (usually from injection) • Drug precipitate, glass, linen fibers

  5. Arteriosclerosis • Hardening of arteries • Fibrotic • Atherosclerotic • Shape • Eccentric • Concentric

  6. Atherosclerosis • Inflammatory disease • Endothelial injury • Fatty streak formation • Fibrotic plaque • Complicated lesion

  7. “Novel” Risk factors CRP Serum fibrinogen Insulin resistance Oxidative stress Infection Periodontal Disease Endothelial Dysfunction • Risk factors • Smoking • High blood pressure • Cholesterol • Sedentary life • Homocysteine • Turbulent blood flow

  8. Injured Endothelium • Inflamed • Produces less vasodilating hormones • Produces less antithrombotic hormones • Inflammatory molecules cause damage • Growth factors released (SMCs) • Macrophages adhere • Oxidation of LDL • Foam Cell formation

  9. Atherosclerotic Plaque • Fatty streaks found in children as young as ten years old • Develops fibrous cap • Hard candy coating on the outside • Delicious liquid center • Complicated lesion • Fibrous cap breaks • Contents spill out • Thrombus forms • Partial or complete occlusion or embolus

  10. Manifestations of Athersclerosis • None until severe or event • Collateral circulation • Legs: Claudication • Coronary: Reduced exercise tolerance • Renal artery: hypertension • CV Event (complicated lesion) • Stroke, MI • Death

  11. Collateral Circulation

  12. Eval & Tx of Atherosclerosis • Risk factors risk factors • Family history • Endothelium function test • Localized perfusion studies • Doppler • ECG, Echo, Angiogram, Stress test • Tx: • Tx BP & cholesterol, anticoagulant • Life style • Treat localized ischemic lesions

  13. Treatment of Localized Lesions • Bypass surgery • Use another artery • Use a piece of vein • CABG, Fem-pop • Heart catheterization (PCI) • Percutaneous Transluminal Angioplasty- PCTA • Stent • Thrombolysis

  14. Peripheral Arterial Disease • Atherosclerotic • Thromboangitis obliterans (Buerger’s Disease) • Raynaud’s disease/phenomenon • Peripheral vasospasm • Treat with alpha-blockers • Raynaud’s phenomenon often accompanies other illnesses • E.g., SLE

  15. Diseases of the Veins • Varicose veins & Venous insufficiency • Enlarged tortuous veins • Failure of valve • May lead to insufficient venous return • Functional decrease in preload • Hyperpigmentation of feet • Edema • Sluggish circulation in lower extremities • Venous stasis ulcers

  16. DVT • ~10-26% of hospitalized patients may develop • Highest risk for shock, stroke, MI, CHF, malignancy • ~100% risk in • Orthopedic trauma/surgery • Spinal cord injury • Some OB/gyn conditions • Patient with coagulation disorders

  17. DVT • Factors that promote DVT • Venous stasis • Immobility, meds, posture • Venous endothelial damage • Hypercoagulable states • Inherited, malignancy, pregnancy, OCs, HRT • Manifestations & Eval • Pain, Swelling, Redness, +Homan’s sign • Doppler ultrasound • Tx: Prevention, Anticoagulation

More Related