Vascular Disorders

• Rheumatic fever


  Acute systematic inflammatory condition that appears to result from an abnormal immune reaction occurring a few weeks after an untreated infection, usually caused by strains of group A betahemolytic Streptococcus
• Rheumatic fever


  • Inflammation involves the heart and other parts such as joints and skin
  • Occurs in children 5 to 15 years old
• Signs and Symptoms of Acute Rheumatic Fever

  • Low grade fever
  • Leukocytosis
  • Malaise
  • Anorexia
  • Fatigue
• Diagnostic Test


  Heart function Test
• Treatment for Rheumatic Fever

  • Antibacterial agents (Penicilin V)
  • Anti-inflammatory agents (ASA or corticosteroids)
• Hypertension


  High blood pressure
• Hypertension


  • Primary and Secondary forms is a very common problem
  • Estimates one in three adults has high blood pressure
  • Men are more likely to have high blood pressure than woman
• Prehypertension


  Elevated blood pressure but not taking medication
• Major categories of Hypertension

  • Primary or essential hypertension
  • Secondary hypertension
  • Malignant hypertension
• Primary or essential hypertension

  Idiopathic, develops when blood pressure is above 140/90, can be mild, moderate or severe
• Secondary hypertension


  Caused by renal or endocrine disease, or benign tumor of adrenal medulla
• Malignant hypertension


  Uncontrollable, severe and rapidly progressive
• End result of poorly controlled hypertension can be chronic renal failure, stroke due to hemorrhage, loss of vision or congestive heart failure
• Factors implicated in the development of essential hypertension

  • High sodium intake
  • Excessive alcohol intake
  • Obesity
  • Prolonged or recurrent stress
• Signs and Symptoms of Hypertension

  • Fatigue
  • Malaise
  • Morning headache
• Treatment for Hypertension


  • Lifestyle changes
  • Reduce salt intake
  • Reduce body weight and stress
  • Increase cardiovascular fitness
• Peripheral Vascular Disease


  Abnormality in the arteries and veins outside the heart
• Peripheral Vascular Disease


  • Increasing fatigue and weakness in the legs development as blood flow decreases
  • Intermittent claudication
• Diagnostic Tests for Peripheral Vascular Disease

  • Ultrasonography
  • Arteriography
  • Plethysmoghraphy
• Treatment for Peripheral Vascular Disease

  • Reduction of serum cholesterol level
  • Reduced thrombus formation
  • Exercise program
• Thromboangiitis Obliterans (Buerger's Disease)


  Inflammatory condition of medium sized and small arteries in the legs and arms, sometimes the veins are involved
• Buerger's Disease affects the small blood vessels, surgical intervention is not feasible
• Buerger's Disease begins in young men before 35 years old
• Raynaud's Syndrome


  Primary Raynaud's Syndrome is common in young woman and considered idiopathic, Secondary Raynaud's Syndrome is associated with many conditions, such as Systemic Lupus Erythematosus (SLE)
• Raynaud's Syndrome is an example of a vasopastic condition
• Aortic Aneurysm


  A localized dilation in an arterial wall, most common location is either the abdominal or thoracic aorta
• Common causes of Aortic Aneurysms

  • Atherosclerosis
  • Trauma
  • Syphilis
  • Other infections as well as congenital defects
• Signs and Symptoms of Aortic Aneurysm

  • Aneurysm - dysphagia from pressure on the esophagus, pain if a spinal nerve is compressed
  • Rupture - severe pain, indications of shock
  • Dissection Aneurysm - severe pain, loss pulses, organ dysfunction
• Diagnostic Tests for Aortic Aneurysms

  • Radiography
  • Ultrasounds
  • CT scans
  • MRI
• Treatment for Aortic Aneurysms

  • Maintain blood pressure at a normal level
  • Preventing sudden elevation due to exertion, stress, coughing, or constipation
  • Surgical repairs with resection and replacement with a synthetic grafy can prevent rupture
• Varicose Veins


  Irregular dilated and tortuous areas of the superficial or deep veins, also found in the esophagus (esophageal varices) and in the rectum (hemorrhoids)
• Causes of Varicose Veins


  • Inherent weakness in the veins walls
  • Valves may be damaged by trauma, intravenous administration of fluids or thrombophlebitis
• Signs and Symptoms of Varicose Veins


  • Superficial varicosities on the legs appear as irregular, purplish, bulging structures
  • Increased, interstitial fluid or edema also leads to a shiny, pigmented, and hairless skin, and varicose ulcers may develop as arterial blood flow continues to diminish and the skin breaks down
• Treatment for Varicose Veins

  • Restrictive clothing should be avoided and the patient should refrain from crossing the legs
  • When a patient must stand for long periods, intermittent voluntary muscles contractions or position changes are helpful
• Thrombophlebitis


  The development of a thrombus in a vein in which inflammation is present
• Phlebothrombosis


  A thrombus forms spontaneously in a vein without prior inflammation, although inflammation may develop secondarily in response to thrombosis
• The critical problem is that venous thrombosis may lead to pulmonary embolism, as a piece of thrombus breaks off and flows in the venous blood returning to the heart
• Signs and Symptoms of Thrombophlebitis and Phlebothrombosis


  • The leg may be warm and red in the area of the acting pain, tenderness, and edema in the affected leg as the blood pools distal to the obstructing thrombus
• Treatment for Thrombophlebitis and Phlebothrombosis


  • Preventing measures, such as exercise, elevating the legs and minimizing the effects of primary conditions are important