VASCULAR

DISORDERS
Medical – Surgical 2
 What is Vascular Disease
•Vascular disease is any abnormal condition of the
blood vessels (arteries and veins). The body uses blood
vessels to circulate blood through itself. Problems
along this vast network can cause severe disability and
death.
•Vascular diseases outside the heart can “present”
themselves anywhere.
 UNDERSTANDING THE VASCULAR SYSTEM
• Your vascular system – the highways of the body – is composed of three
types of blood vessels.
• Arteries carry oxygen-rich blood from the heart, nourishing every part of the
body. The aorta is the largest blood vessel of all.
• Veins carry the blood back to the heart where it is replenished with oxygen.
• Capillaries connect the arteries to the veins.
• There are 100,000 miles of blood vessels in the adult human body. Any
problem along this vast network of blood vessels – the vascular system – can
cause severe pain, disability and death.
 CORONARY ARTERY DISEASE (CAD)
• Coronary artery disease (CAD), These are diseases of the arteries
that supply the heart muscle with blood. CAD is one of the most
common forms of heart disease and the leading cause of heart
attacks. It generally means that blood flow through the coronary
arteries has become obstructed. The most common cause of such
obstructions is a condition called atherosclerosis, a largely
preventable type of vascular disease. Coronary artery disease can
lead to other heart problems, such as chest pain (angina) and heart
attack (myocardial infarction-MI).
 MYOCARDIAL
INFARCTION (MI)

• A heart attack (medically

known as a myocardial
infarction) is a deadly
medical emergency where
your heart muscle begins to
die because it isn't getting
enough blood flow. This is
usually caused by a blockage
in the arteries that supply
blood to your heart.
 ANGINA PECTORIS
• Angina pectoris, or just
angina, is temporary chest
pain or discomfort
caused by decreased
blood flow to the heart
muscle. Because of the
decreased flow of blood,
there is not enough oxygen
to the heart muscle
resulting in chest pain.
 Some types of blood vessel disorders:
• Arteriosclerosis and atherosclerosis.
• High blood pressure (hypertension).
• Stroke.
• Aneurysm.
• Peripheral arterial disease and claudication.
• Vasculitis.
• Venous incompetence.
• Venous thrombosis.
• Varicose veins.
• Lymphedema
 ARTERIOSCLEROSIS AND ATHEROSCLEROSIS

• Arteriosclerosis and Atherosclerosis, are conditions in which the walls of

the arteries become thick and stiff. This can sometimes restrict blood flow to
the organs and tissues. The process of this thickening and stiffening is
arteriosclerosis. Atherosclerosis is the most common form of arteriosclerosis.
Although the two terms are often used interchangeably, atherosclerosis refers
to hardening of the arteries caused by accumulation of fatty deposits
(plaques) and other substances. The heart is one of the organs commonly
affected by atherosclerosis. When the arteries of the heart (coronary arteries)
narrow – may experience chest pain or a heart attack.
 High blood pressure (hypertension)
•High blood pressure (hypertension), is the excessive force of
blood pumping through the blood vessels. It's perhaps the most
common form of cardiovascular disease in the Western world,
affecting about one in four Americans. Although potentially
life-threatening, it’s one of the most preventable and treatable
types of cardiovascular disease. High blood pressure also causes
many other types of cardiovascular disease, such as stroke and
heart failure.
 Stroke & Aneurysm
• Stroke, is a sudden loss of brain function. It occurs when blood flow
to the brain is interrupted (ischemic stroke) or when blood vessels in
the brain rupture (hemorrhagic stroke). These, in turn, cause the death
of brain cells in the affected areas. Stroke is often thought of as a
neurological disorder because of the many complications it causes.
• Aneurysm, is a bulge or weakness in the wall of an artery or vein.
Aneurysms usually enlarge over time. Because of that, they have the
potential to rupture and cause life-threatening bleeding. Aneurysms
can occur in arteries in any location in the body. The most common
sites include the abdominal aorta and the arteries at the base of the
brain.
 PERIPHERAL ARTERIAL DISEASE
• Peripheral arterial disease and claudication, may be more familiar with
claudication — pain in the arms or legs during exercise — than the term
"peripheral arterial disease." Strictly speaking, claudication is a symptom of
peripheral arterial disease. However, claudication is often referred to as a
disease itself. Peripheral arterial disease is a disorder in which the arteries
supplying blood to the limbs — usually the legs — become clogged or
partially blocked. When this happens, the arms and legs are left with less
blood than they need to keep up with demand. Claudication symptoms may
then develop. When the obstruction is mild, may have such symptoms as
pain in the legs during strenuous exercise. As the disease progresses and
arteries become more obstructed, may have pain or cramping in the legs
even when not active
 • Vasculitis, This is an inflammation
of the blood vessels. It usually
involves the arteries but may also
affect veins and capillaries. The
inflammation may damage the wall
of the artery or vein and impair
blood flow to the region of the body
supplied by that vessel. Sometimes
vasculitis occurs along with a
generalized disorder, such as lupus
or rheumatoid arthritis, but it may
also occur on its own.

VASCULITIS
 VENOUS INCOMPETENCE
• Venous incompetence, This is a condition in which blood
flows the wrong way in the veins. Veins have tiny valves
that are designed to promote blood flow in a forward
direction, back to the heart. But if such conditions as
infection, inflammation, abnormal blood clotting, or even
high-back pressure in pregnancy, the valves may become
damaged and incompetent. That allows blood to flow
backward and pool in the legs when sitting or standing. May
develop such complications as prominent and painful
varicose veins, skin changes, ulcers and swelling in the legs.
When venous incompetence occurs in the arms, may
experience pain and swelling in the arms and prominent
veins.
VENOUS INCOMPETENCE
 VENOUS THROMBOSIS
• Venous thrombosis, This is the
formation of a blood clot
(thrombus) in a vein. This condition
may damage the vein and its valves.
In addition, clots that break off and
travel in the bloodstream can lodge
in the lungs, a condition known as
pulmonary embolism. In some
cases, this type of clot can also
cause a stroke. May be more
familiar with deep vein thrombosis,
in which a clot develops deep within
a muscle.
 Varicose veins & Lymphedema
• Varicose veins, This is a condition in which the veins
become twisted and enlarged. The veins are usually
located on the backs of the calves or on the inside of the
legs, from the groin to the ankle. When valves in the
veins don't function properly, blood can accumulate in
the legs, causing the veins to bulge and twist. The veins
appear blue because they contain less oxygen.
• Lymphedema, This is an obstruction of the lymphatic
vessels. It results in an excessive buildup of fluid, which
can cause swelling and pain. It can be caused by
infections, trauma, tumors, surgery and radiation
treatment. In rare cases, someone may be born with
lymphedema.
 ARTERIES WHERE THE MOST COMMON AREAS OF
PROBLEM:

• ARCH BRANCHES
• Arch Branches supply blood to the brain through the carotid arteries,
and when diseased, frequently cause life threatening strokes.
• CORONARY ARTERIES
• Coronary arteries supply blood to the heart and, when diseased, can
block the flow of blood and cause a heart attack. This is a
cardiovascular disease and is primarily managed by heart specialists –
cardiologists.
 ARTERIES WHERE THE MOST COMMON AREAS OF
PROBLEM:

• ILIAC ARTERIES
• Iliac Arteries supply blood to the hips and the legs and, when diseased,
cause leg pain with walking (claudication), often in both legs.
• RENAL ARTERIES
• Renal Arteries supply blood to the kidneys and, when diseased, can
cause high blood pressure and eventually, kidney failure.
 ARTERIES WHERE THE MOST COMMON AREAS OF
PROBLEM:

• FEMORAL ARTERIES
• Femoral Arteries supply blood to the legs. If they become diseased, it
may cause claudication, usually in the calf muscles. This lack of
circulation can lead to continuous pain in the toes and foot and may
progress to critical limb-threatening ischemia.
 Ischemia

• Ischemia - Ischemia is
a condition in which the blood
flow (and thus oxygen) is
restricted or reduced in a part
of the body. Cardiac ischemia
is the name for decreased blood
flow and oxygen to the heart
muscle.
ISCHEMIA
AND
INFARCTION
 COMMON VASCULAR DISEASES
• Vascular diseases outside the heart can “present” themselves anywhere. The most
common vascular diseases are:
stroke,
peripheral artery disease (PAD),
abdominal aortic aneurysm (AAA),
carotid artery disease (CAD),
arteriovenous malformation (AVM),
critical limb-threatening ischemia (CLTI),
pulmonary embolism (blood clots),
deep vein thrombosis (DVT),
chronic venous insufficiency (CVI),
and varicose veins.
STROKE
•Stroke - A stroke occurs when
the blood supply to part of
your brain is interrupted or
reduced, preventing brain
tissue from getting oxygen and
nutrients. Brain cells begin to
die in minutes. A stroke is a
medical emergency, and
prompt treatment is crucial.
Early action can reduce brain
damage and other
complications
 Signs & Symptoms (S/Sx) of Stroke

• Sudden numbness or weakness in the face, arm, or leg, especially on

one side of the body.
• Sudden confusion, trouble speaking, or difficulty understanding
speech.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance, or lack of
coordination.
• Sudden severe headache with no known cause.
• Call 9-1-1 right away if you or someone else has any of these
symptoms.
 Peripheral Arterial Disease (PAD)

• Peripheral arterial disease (PAD) in the

legs or lower extremities is the
narrowing or blockage of the vessels
that carry blood from the heart to the
legs. It is primarily caused by the
buildup of fatty plaque in the arteries,
which is called atherosclerosis. PAD can
happen in any blood vessel, but it is
more common in the legs than the arms.
 S/Sx PAD
• The classic symptom of PAD is pain in the legs with physical activity, such
as walking, that gets better after rest. However, up to 4 in 10 people with
PAD have no leg pain.1 Symptoms of pain, aches, or cramps with walking
(claudication) can happen in the buttock, hip, thigh, or calf.
• Physical signs in the leg that may indicate PAD include muscle atrophy
(weakness); hair loss; smooth, shiny skin; skin that is cool to the touch,
especially if accompanied by pain while walking (that is relieved by stopping
walking); decreased or absent pulses in the feet; sores or ulcers in the legs or
feet that don’t heal; and cold or numb toes.
 What are the risk factors for PAD?

• Smoking
• High blood pressure
• Atherosclerosis
• Diabetes
• High cholesterol
• Age above 60 years
• If you have PAD, you are at risk for developing coronary artery
disease and cerebrovascular disease, which could lead to a heart attack
or stroke.
Peripheral vascular disease
(PVD) is a slow and
progressive circulation
disorder. Narrowing,
blockage, or spasms in a
blood vessel can cause
PVD. PVD may affect any
blood vessel outside of the
heart including the arteries,
veins, or lymphatic vessels.
 PERIPHERAL ARTERIAL DISEASE vs.
PERIPHERAL VASCULAR DISEASE
• PAD (the specific disease) is caused by the buildup of a fatty, sticky
substance called plaque on the inner surfaces of the arteries leading to your
legs. This condition is known as atherosclerosis, but you may have also
heard it referred to as “hardening of the arteries.”
• No matter what you call it, it’s dangerous. The narrowing of the arteries
restricts the amount of blood flowing to the legs, feet, and toes. Your lower
extremities can’t get the oxygen and nutrients they need to stay healthy. So,
they begin to fail, in many ways. Common symptoms of PAD include leg
pain, sores and wounds that won’t heal, and loss of mobility. Extreme
symptoms of PAD include tissue death (gangrene), which can lead to
amputation.
 PERIPHERAL ARTERIAL DISEASE vs.
PERIPHERAL VASCULAR DISEASE

• As noted above, PVD refers to a number of different conditions.

Some of them also affect arteries. Blockage to the coronary
arteries feeding the heart, for example, can cause angina or a
heart attack. Blockage in arteries feeding the kidneys can cause
high blood pressure and heart failure. If arteries leading to the
brain become blocked, the result can be a stroke or transient
ischemic attack.
 ABDOMINAL AORTIC
ANEURYSM
• An abdominal aortic aneurysm is an enlarged area
in the lower part of the major vessel that supplies
blood to the body (aorta). The aorta runs from the
heart through the center of the chest and abdomen.
1. Aorta - the main artery of the body, supplying
oxygenated blood to the circulatory system. In
humans it passes over the heart from the left
ventricle and runs down in front of the backbone.
• An aneurysm is a ballooning at a weak spot in
an artery wall. An aneurysm's walls can be thin
enough to rupture
 SYMPTOMS

• Abdominal aortic aneurysms often grow slowly without noticeable

symptoms, making them difficult to detect. Some aneurysms never
rupture. Many start small and stay small. Others grow larger over time,
sometimes quickly.
• If you have an enlarging abdominal aortic aneurysm, you might
notice:
• Deep, constant pain in the belly area or side of the belly (abdomen)
• Back pain
• A pulse near the bellybutton
 Causes

• Aneurysms can develop anywhere along the aorta, but most aortic aneurysms
occur in the part of the aorta that's in the belly area (abdomen). Several things
can play a role in the development of an abdominal aortic aneurysm, including:
• Hardening of the arteries (atherosclerosis). Atherosclerosis occurs when fat
and other substances build up on the lining of a blood vessel.
• High blood pressure. High blood pressure can damage and weaken the aorta's
walls.
• Blood vessel diseases. These are diseases that cause blood vessels to become
inflamed.
• Infection in the aorta. Rarely, a bacterial or fungal infection might cause an
abdominal aortic aneurysms.
• Trauma. For example, being injured in a car accident can cause an abdominal
aortic aneurysms.
CAROTID ARTERY DISEASE (CAD)

• Coronary artery disease, also called CAD,

coronary or atherosclerotic heart disease, is a
serious condition caused by a buildup of plaque
in your coronary arteries, the blood vessels that
bring oxygen-rich blood to your heart.
• Your arteries are smooth and elastic. But when
plaque builds up on their inner walls, it can
make them stiff and narrow. This
slows blood flow to your heart muscle, so it
doesn’t get the oxygen it needs.
 Coronary Artery Disease Symptoms
• The most common symptom is angina, or chest pain.
• Angina - Angina is chest pain or discomfort caused when your heart muscle doesn't
get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The
discomfort also can occur in your shoulders, arms, neck, jaw, or back
• People describe angina as:
• Aching
• Burning
• Fullness
• Heaviness
• Numbness
• Pressure
• Squeezing
• Weakness or dizziness
 Coronary Artery Disease Symptoms
• You might mistake it for indigestion or heartburn.
• You usually feel angina in your chest, but you might feel it in your:
• Arms
• Back
• Jaw
• Neck
• Shoulder
• Faster heartbeat
• Nausea
• Palpitations
• Shortness of breath
• Sweating
• Weakness or dizziness
 Coronary Artery Disease Risk Factors
• Many things can make you more likely to have coronary artery disease. Some you
can change, and some you can’t. They include:
• Age, especially being older than 65
• Being overweight or obese
• Diabetes
• Family history, especially if one of your close relatives got heart disease at a
young age
• Gender. Men have a greater risk of heart attack and have them earlier, compared
with women, until the risk evens out at age 70.
• High blood pressure and high cholesterol
• High stress
• Lack of physical activity
• Smoking or breathing secondhand smoke
• Unhealthy diet, including a lot of food that has high saturated fat, trans fat, salt,
and sugar
 DEEP VEIN
THROMBOSIS
• Deep vein thrombosis
(DVT) is a medical
condition that occurs
when a blood clot
forms in a deep vein.
These clots usually
develop in the lower leg,
thigh, or pelvis, but they
can also occur in the
arm.
 DVT
• DVT is blood clotting that develops with deep veins, often in the leg or pelvis.
• If the thrombus, or clot, breaks off, doctors call this an embolus. Emboli can make their way to the
lung, causing a PE.
• Symptoms
• Some people may develop DVT without noticing symptoms. However, if symptoms develop, they
may resemble the following:
• pain in the affected limb that begins in the calf
• swelling in the affected limb
• a warm feeling in the swollen, painful region of the leg
• red or discolored skin
• In most people, DVT only develops in one leg. However, on rare occasions, both legs may have
DVT.
• If a clot dislodges and travels to the lung, the following symptoms may indicate PE:
• slow breathing or sudden breathlessness
• chest pain, usually more severe while breathing deeply
• rapid breaths
• a faster heart rate
 A pulmonary
embolism is a blood
clot in the lung that
occurs when a clot in
another part of the
body (often the leg or
arm) moves through
the bloodstream and
becomes lodged in
the blood vessels of
the lung
VARICOSE VEINS
are twisted, enlarged veins.
Any superficial vein may
become varicosed, but the veins
most commonly affected are
those in your legs. That's
because standing and walking
upright increases the pressure in
the veins of your lower body.
 VARICOSE VEINS
• Symptoms
• Varicose veins may not cause any pain. Signs you may have varicose veins
include:
• Veins that are dark purple or blue in color
• Veins that appear twisted and bulging; they are often like cords on your legs
• When painful signs and symptoms occur, they may include:
• An achy or heavy feeling in your legs
• Burning, throbbing, muscle cramping and swelling in your lower legs
• Worsened pain after sitting or standing for a long time
• Itching around one or more of your veins
• Skin discoloration around a varicose vein
 Everyone is at risk for vascular disease

• . With the increase in obesity and Type II diabetes and as the

population ages, vascular diseases are becoming epidemic. It can
occur in anyone at any time; affecting men and women equally.
Atherosclerosis can begin in adolescence.
• Atherosclerosis - is the buildup of fats, cholesterol and other
substances in and on your artery walls.
• Vascular disease commonly occurs at sites of turbulent blood flow,
such as when the blood flow in the arteries changes direction abruptly.
The arteries below are the most common areas of turbulence:
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