vascular Flashcards
causes of peripheral vascular disease
athersclerosis - narrows affected arteries
risk factors peripheral vascular disease
smoking
DM
hypertension
dyslipidaemia
presentation of peripheral vascular disease
acute limb ischaemia - when onset of leg pain over minutes, hours or days = pulseless, pallor, painful, paraesthesia, paralysis and perishingly cold
chronic limb ischaemia = progressive development of cramp like pain in calf on walking or unexplained foot pain at rest or worse at night.
non healing wounds on lower limb
peripheral pulses absent or may be difficult to feel
investigations of peripheral vascular disease
blood pressure
FBC, ESR, thrombophilia screen + homocysteine
fasting blood glucose
lipid level
ECG - most with intermittent claudication have pre existing coronary heart disease
treatment of peripheral vascular disease
lifestyle - smoking cessation, regular exercise, weight reduction,
ACE i
statins
manage diabetes
antiplatelet durgs
peripheral vasodilators - naftidrofuryl oxalate
angioplasty or bypass surgery - inconclusive if this is better than lifestyle changes
who gets AAA
more in men
>65
causes of AAA
degenerative process
genetic component
risk factors of AAA
family history
marfans
age
presentation of AAA
often no symptoms
only causes symptoms if pressure effects or ruptures
pressure effects symptoms: mild abdo/back pains
blood clots can form which block other vessels
if ruptures = sudden, severe abdo and back pain and collapse
signs on examination of AAA
large expansile mass
investigations of AAA
USS or CT for diagnosis
USS screening programme
treatment of AAA
surgical replacement of aneurysmal segment with prosthetic graft for symptomatic
endovascular repair with insertion of aortic stent in large asymptomatic in patients with poor surgical risk
who gets varicose veins
W>M
pregnant ladies in particular
causes of varicose veins
incompetent valves in affected vein = reflux of blood and increased pressure in vein distally
increase in venous pressure usually particularly marked if also incompetence in deep veins
varicose veins appear to worsen in pregnancy - increased blood volume, hormones cause relaxation of muscle walls or blood vessels, enlarged uterus putting pressure on pelvic veins and IVC
risk factors for varicose veins
age sex -F family history obesity standing or sitting for long periods of time
