Vascular Pathologies

Question 1

Aneurysm Etiology

Answer 1

congenital defect, weakness in wall of vessel often due to chronic hypertension, connective tissue disease (Marfan Syndrome), trauma, infection

Question 2

Aneurysm Signs/Symptoms

Answer 2

**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

Question 3

Aneurysm Treatment

Answer 3

Antihypertensive meds for hyptertension

Surgery to repair aortic aneurysm- break in vessel wall is replaced with synthetic fabric graft

Question 4

Angina Pectoris: Stable

Answer 4

Occurs @ predictable level of exertion/exercise/stress, responds to rest/nitroglycerin

Question 5

Angina Pectoris: Unstable

Answer 5

usually more intense, lasts longer, precipitated by less exertion, occurs spontaneously @ rest, is progressive, or combo of above features

Question 6

Angina Pectoris: Prinzemental (variable)

Answer 6

occurs due to coronary artery spasm associatedw/ Coronary Artery Disease (CAD)

Question 7

Angina Pectoris Etiology

Answer 7

inadequate blood floe and oxygenation of heart muscles due to CAD

Question 8

Angina Pectoris Signs/Symptoms

Answer 8

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

Question 9

Angina Pectoris Treatment

Answer 9

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

Question 10

Atherosclerosis Etiology

Answer 10

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

Question 11

Atherosclerosis Signs/Symptoms

Answer 11

** 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

Question 12

Atherosclerosis Treatment

Answer 12

lifestyle changes: quit smoking, regular exercise, healthy diet, stress management

meds: antihypertensive, anti-platelet, anti-lipidemic agents
surgery: angioplasty, endarterectomy, bypass

Question 13

Chronic Venous Insufficiency (CVI) Etiology

Answer 13

weak/ damaged valves in veins

Risk factors: age, being female, obesity, pregnancy, prolonged sitting/standing

Question 14

CVI Signs/Symptoms

Answer 14

leg swelling, varicose veins, aching, heaviness/cramping, itchiness, redness/ skin ulcers of legs/ankles

Question 15

CVI Treatment

Answer 15

compression stockings + elevation of legs to decrease chronic swelling
varicose vein stripping for persistent leg pain/ skin ulcers due to poor circulation

Question 16

Cor Pulmonale Etiology (pulmonary artery disease)

Answer 16

pulmonary hypertension form chronically increased resistance in pulmonary circulation

Question 17

Cor Pulmonale Signs/Symptoms

Answer 17

progressive shortness of breath especially w/ exertion

also fatigue, palpitations, atypical chest pain, swelling in LE, dizziness and syncope

Question 18

Cor Pulmonale Treatment

Answer 18

supplemental O2 sufficient to maintain SaO2> 90% and/or PAO2> 60 mmHg
may also include diuretics & anticoagulants

Question 19

Coronary Artery Disease (CAD) Etiology

Answer 19

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

Question 20

CAD Signs/Symptoms

Answer 20

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

Question 21

CAD Treatment

Answer 21

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

Question 22

Deep Vein Thrombosis (DVT) Etiology

Answer 22

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

Question 23

DVT Signs/Symptoms

Answer 23

about 50% of cases are asymptomatic

may show swelling, pain, redness, warmth in affected leg

Question 24

DVT Treatment

Answer 24

GOAL: prevent blood clot from getting bigger/ breaking loose & causing pulmonary embolism
Meds: anticoagulants, thrombolytics
Prevent: compression stockings to reduce blood pooling in LE

Question 25

(Congestive) Heart Failure (CHF) Etiology

Answer 25

coronary artery disease (CAD), hypertension, diabetes mellitus, myocardial infarction, abnormal heart valves, cardiomyelopathy

Question 26

CHF Signs/Symptoms

Answer 26

shortness of breath, fatigue/weakness, swelling in legs/feet/abdomen, rapid/irregular heartbeat, persistent cough/wheezing, weight gain from fluid retention

Question 27

CHF Treatment

Answer 27

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

Question 28

Hypertension Etiology

Answer 28

Primary (essential) = no known cause | Secondary = usually due to renal disease

Question 29

Hypertension Signs/Symptoms

Answer 29

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

Question 30

Hypertension Treatment

Answer 30

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

Question 31

Hypertension Classifications:

Answer 31

Normal BP:

Question 32

Myocardial Infarction (aka Heart attack) Etiology

Answer 32

ruptured atherosclerotic plaque, blood clot blocks flow through coronary artery *uncommon* = coronary artery spasm

Question 33

Myocardial Infarction Signs/Symptoms

Answer 33

chest discomfort w/ pressure, squeezing/pain, shortness of breath, UE discomfort (arms, shoulder, neck/back), nausea, vomiting, dizziness, sweating, and palpitations

Question 34

Myocardial Infarction Treatment

Answer 34

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

Question 35

Peripheral Artery Disease Etiology

Answer 35

primary = atherosclerosis, thromboembolic processes alter structure/function of aorta and its branches

Question 36

Peripheral Artery Disease Signs/Symptoms

Answer 36

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

Question 37

Peripheral Artery Disease Treatment

Answer 37

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

Question 38

Valvular Heart Disease Etiology

Answer 38

congenital defect, calcific degeneration, infective endocarditis, CAD, myocardial infarction, rheumatic fever

Question 39

`Valvular Heart Disease Signs and Symptoms

Answer 39

varies based on type/severity of valve disease- may include heart palpitation, shortness of breath, chest pain, coughing, ankle swelling and fatigue

Question 40

Valvular Heart Disease Treatment

Answer 40

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