Cs - Cardiology - Vascular Diseases

Front 1

Peripheral Vascular Disease (PVD)

Back 1

Epi: Worse in eldery,
Eti: Atherosclerosis
RF: Coronary Artery Disease,
Path: Deceased flow in arteries due to the build-up of Atherosclerosis
Sx: Location is usually in the legs Claudication (aching, cramping), Foot ulcers, Decreased systolic blood pressure arm-to-leg ratio, Smooth shiny hairless skin, Muscle atrophy, Diminished distal pulses, Audible bruits, Ischemia
Px:
Tx: Smoking cessation, Walking, Pentoxifylline (vasodialtion and decreased platelet aggregation), Revascularization
Note:

Front 2

Acute Limb Ischemia

Back 2

Epi:
Eti: Thrombus or embolus
RF:
Path: Sudden occlusion of a peripheral artery
Sx: Pain, Claudication, Cold, Cyanosis, Absent pulse, Diminished function
Px:
Tx: Anticoagulation, Embolectomy, Catheter-Directed (tPA) infusion
Note: VASCULAR EMERGENCY

Front 3

Abdominal Aortic Aneurysm

Back 3

Epi: Common in older adults, more in men
Eti: Atherosclerosis, Cystic Medial Necrosis, Vasculitis w/ CT disease, Chronic infection
RF: Age, Smoking, Hypertension, FMHx
Path: Bulging of the Aorta due to degeneration of the vessel wall
Sx: Non-tender pulsatile mass BELOW the umbilicus, Hypotension, Ripping/tearing pain
Px: Not good if it ruptures
Tx: Smoking cessation, Cholesterol reduction, Surgical repair,
Note: Emergency if it is 5cm or bigger

Front 4

Aortic Dissection

Back 4

Epi:
Eti:
RF: Hypertension, Cocaine use, Trauma, Hereditary CT disease, Vasculitis
Path: Intimal layer is torn from aortic wall leading to the formation of a false lumen in parallel with the true lumen
Sx: Severe chest and back pain, Syncope, Pericardial Tamponade, Pulse deficits, Hypotension
Px: Fatal w/o treatment
Tx: Surgical repair, Blood pressure control
Note:

Front 5

Aortic Dissection Classifications

Back 5

Stanford System:
Type A- Involves Ascending aorta
Type B- Involves the distal aorta

Debakey System:
Type I- Dissection involves the entire aorta
Type II- Involves only the ascending aorta
Type III- Involves only the descending aorta

Front 6

Raynaud's Phenomenon

Back 6

Epi:
Eti:
RF:
Path: Vasospasm of the small arteries of the hands and feet
Sx: Digital ischemia, Pallor, Cyanosis, Erythema, Digital ulcers or thickening of pad
Px:
Tx: Avoid cold temps
Note: Characteristic White-Blue-Red color sequence

Front 7

Thromboangiitis Obliterans
(Buerger's Disease)

Back 7

Epi: Mostly younger men before 45
Eti:
RF: Smoking
Path: Non-atherosclerotic disease of the small-medium sized arteries due to inflammatory process and hypercoagulable condition
Sx: Claudation of extremities, Skin changes, Progressive ischemia in extremities leading to loss
Px: Good if they quit smoking
Tx: Smoking Cessation, Amputation, Prostacyclin analog to reduce ischemia
Note: Linked to SMOKING

Front 8

Giant-Cell Arteritis

Back 8

Epi: Elderly, more common in females
Eti:
RF:
Path: Inflammation of the lining of medium-large arteries, Large vessels vasculitis, Immune mediated
Sx: Headache from Temporal Arteritis (classic presentation), Jaw claudication, Visual loss, Chest pain, Scalp tenderness, Low grade fever, Pale and edematous fundus
Px:
Tx: High dose corticosteroids
Note:

Front 9

Takayasu's Arteritis

Back 9

Epi: Common in young women from Asian descent
Eti:
RF:
Path: Ganulomatous vasculitis of the aorta, its main branches and the pulmonary artery, Inflammatory process in the vascular wall can lead to stenosis and aneurysm formation
Sx: Bruits over subclavian artery, Diminished brachial pulses, Low brachial artery blood pressure
Px:
Tx: Corticosteroids, Immunosuppressive agents, Revascularization
Note: Hypertension is most common sign

Front 10

Arteriovenous Fistulas

Back 10

Epi:
Eti: Congenital or Acquired
RF:
Path: Abnormal vascular communications which shunt blood flow from arterial to venous system, bypassing capillary beds and causing decreased tissue profusion
Sx: Pulsatile mass, Bleeding from spontaneous rupture, Bruits, Bone malformations, Neurological deficits (if in the brain)
Px:
Tx: Surgical resection, transcatheter embolization
Note:

Front 11

Venous Thromboembolic Disease

Back 11

Epi:
Eti:
RF: Virchow's Triad (Endothelial damage, Venous stasis, Hypercoagulation), Trousseau's Syndrome (Migratory thrombophlebitis with noninfectious vegetation of the heart valves typically in the setting of mucin-secreting adenocarcinoma), Hypercoagulable state (Includes hereditary diseases)
Path: Presence of coagulated blood or thrombus in a vein
Sx: (PE and DVT symptoms)
Px:
Tx: Anticoagulants, Thrombolytics
Note: Encompasses both DVT and PE

Front 12

Deep Vein Thrombosis

Back 12

Epi:
Eti: Surgery, Immobility, Birth Control Pills, Atrial Fibrillation, Cancer, Heart Failure, Pregnancy, Venous Catheter
RF:
Path: Coagulation or thrombus generation in the venous system
Sx: Asymptomatic, Pain with Dorsiflexion (Homan's sign), Swelling, Tenderness, Erythema, Warmth, Palpable tender cord, Dilated superficial veins
Px:
Tx: Heparin (1st), Warfarin (2nd), Fibrinolytic infusion, Inferior Vena Cava,
Note: Most begin in CALF, DUPLEX ULTRASONOGRAPHY study of choice

Front 13

Pulmonary Embolism

Back 13

Epi:
Eti: Surgery, Immobility, Birth Control Pills, Atrial Fibrillation, Cancer, Heart Failure, Heart Failure, Pregnancy, Venous Catheter
RF: DVT
Path: Dislodged thrombus from deep veins that migrates to lungs and blocks a pulmonary artery
Sx: Sudden onset of dyspnea, Angina, Syncope, Hemoptysis, Tachypnea, Tachycardia, Crackles, Wheezes Pleural rub
Px:
Tx: Anticoagulation (Immediately), Thrombolytics
Note: Spiral Chest CT Angiography MODALITY OF CHOICE