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Cardiac & Vascular Disorders
Alterations in Arterial Flow
17
Pathology
Undergraduate 3
03/17/2014

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Term
Arteriosclerosis
Definition
Hardening of arteries; atherosclerosis most common form
Most common cause of CHRONIC arterial obstruction
Risk factor for cardiovascular disease
Term
Arteriosclerosis pathogenesis
Definition
Thickening & luminal narrowing of medium & large arteries (carotid, coronary, cerebral, femoral)
Damage to arterial intima w/ inflammation & increase in vessel wall permeability
Permeability allows LDLs to breach intimal layer (uh-oh!)
Platelets aggregate at site of injury
Stimulation causes muscle cells to proliferate resulting in atherosclerotic plaque
Plaques slowly enlarge, decreasing orifice of artery
May rupture --> emboli
Term
Modifiable atherosclerotic risk factors
Definition
Smoking
Diet (elevated cholesterol & LDLs)
Elevated BP
Glucose intolerance
Decreased physical activity
Obesity
Weight fluctuations
Ineffective stress management
Term
Non-modifiable risk factors for atherosclerosis
Definition
Age
Ethnicity
Heredity
Gender
Term
Hyperlipidemia risk factors
Definition
Men >45; women >55
Personal or family history
Smoking
HTN
Low HDL
DM
Dietary excess of calories, saturated fats, cholesterol
Obesity
High triglyceride diets
Term
Lipidemia levels
Definition
LDL <100
HDL men >45; women >55
Total cholesterol <200
Term
Hyperlipidemia treatment
Definition
Diet modification
Exercise
Smoking cessation
Weight loss
Meds after 3 months of altering lifestyle
Term
Atherosclerosis clinical manifestations
Definition
Varies w/ tissues involved & severity of altered blood flow
Term
Atherosclerosis treatment
Definition
Begin by altering modifiable risk factors (lifestyle changes)
Meds to reduce cholesterol
Balloon angioplasty
Balloon angioplasty w/ stent
Coronary Artery Bypass Graft (CABG)
Term
Peripheral Artery Disease (PAD) etiology
Definition
Athersclerosis involving peripheral vascular system (Atherosclerosis obliterans)
Disease of superficial vessels (usually legs)
Seen most in older men
Risk factors are same as for atherosclerosis
Term
PAD pathogenesis
Definition
Fat attachment to intima of vessel
Inflammation, healing, scarring,
Soft lipid core beneath intima & scar tissue
Proliferation of blood vessel (diameter & lesions)
Thrombosis
Surgery, meds
Term
PAD clinical manifestations
Definition
Skin: cool; decreased/absent hair; dry, thin, glossy; think nails; pallor when elevated, rubor when dependent; diminished or absent pulses
Pain: sharp, stabbing; intensified w/ activity (intermittent claudication); relieved by rest
Ulcer: very painful & gray
Term
Raynaud Syndrome
Definition
Vasospams of small vessels in digits
More common in women; begins in adolescence
Precipitated by cold or emotional stress
Color changes: pallor, cyanosis, hyperemia
CCBs to vasodilate
Term
Aneurysm etiology
Definition
Localized arterial dilations
Arterial wall deteriorates until it bulges out
D/t vascular structure that has lost elasticity & weakened
Atherosclerosis & HTN major causes
Most occur in abdominal aorta, brain, & thoracic aorta
High morbidity/mortality when rupture occurs
Term
Aneurysm clinical manifestations
Definition
Abdominal: sudden, severe, tearing pain radiating to back of abdomen; may have decreased renal blood flow &/or spinal nerves/head & upper extremities; renal failure
Cerebral: increasing intracranial pressure, stroke
May have absent pulse in one extremity
Visible pulsation of aorta - do not palpate
Term
Aneurysm complications
Definition
Rupture - death occurs w/i minutes
Dissections - tear in intima
Hemorrhage
Term
Aneurysm treatment
Definition
Dx w/ multiple scans
Control BP & blood volume
Smoking cessation
Once leakage begins, surgical repair is necessary
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