Aortic and peripheral vascular disease

Aortic diseases

Aortic aneurysm About aortic anatomy About aortic anatomy What is an aneurysm? What is an aneurysm? What do you know about pseudoaneurym? What do you know about pseudoaneurym? Classification Classification -form -form -location -location Etiology Etiology - atherosclerosis - atherosclerosis -cystic medial necrosis -cystic medial necrosis -syphilis -syphilis -tuberculosis -tuberculosis -mycotic aneurisms -mycotic aneurisms -vasculitis -vasculitis 1.Takayaseu disease 1.Takayaseu disease 2.giant cell arteritis 2.giant cell arteritis 3.others 3.others - traumatic - traumatic -congenital -congenital

Thoracic aortic aneurysm What is the most important etiology? What is the most important etiology? When may it rupture? When may it rupture? What are the symptoms? What are the symptoms? How can you diagnose it? How can you diagnose it? When should you do the surgery? When should you do the surgery? How should you follow it up? How should you follow it up?

Abdominal aortic aneurysm Is there any sex and age difference? Is there any sex and age difference? The most common etiology? The most common etiology? Risk of rupture? Risk of rupture? Symptom and signs? Symptom and signs? How can you diagnose it? How can you diagnose it? What is the treatment? What is the treatment?

Aortic dissection One of the most catastrophic events in field of cardiology and One of the most catastrophic events in field of cardiology and even medicine even medicine Classification Classification Etiology Etiology - hypertension - hypertension -cystic medial degeneration -cystic medial degeneration -Marfan syndrome -Marfan syndrome - inflammatory aortitis - inflammatory aortitis -congenital aortopathy -congenital aortopathy -pregnancy -pregnancy Age and gender differences Age and gender differences

Symptom and signs Symptom and signs Diagnostic tests Diagnostic tests Treatment Treatment -do not forget that treatment is started -do not forget that treatment is started with the diagnosis with the diagnosis -medical therapy with beta blocker and -medical therapy with beta blocker and nitroprusside nitroprusside -do not use pure vasodilators such as -do not use pure vasodilators such as diazoxide and hydralasine diazoxide and hydralasine -surgery -surgery

Aortitis Takayasu ’ s disease Takayasu ’ s disease -involves aortic arch and its branches -involves aortic arch and its branches -mostly in Asian women -mostly in Asian women -acute and chronic phases -acute and chronic phases Giant cell arteritis Giant cell arteritis -involves large and medium-sized arteries -involves large and medium-sized arteries -focal granulomatosis lesions -focal granulomatosis lesions -corticosteroids are the base of treatment -corticosteroids are the base of treatment

Peripheral vascular diseases

Chronic arterial disease Do not forget the role of atherosclerosis and its etiology Do not forget the role of atherosclerosis and its etiology Pathology Pathology Clinical course and symptoms Clinical course and symptoms Paraclinical tests Paraclinical tests Prognosis Prognosis Medical therapy Medical therapy Surgical therapy and interventions Surgical therapy and interventions

Acute arterial occlusion Do not forget it ’ s an emergent situation,don ’ t Do not forget it ’ s an emergent situation,don ’ t loss the golden time loss the golden time Predisposing factors: emboli and thrombosis Predisposing factors: emboli and thrombosis Clinical symptoms&signs (5P:pallor,pain,paresthesia,paralysis and pulselesness) Clinical symptoms&signs (5P:pallor,pain,paresthesia,paralysis and pulselesness) Angiography Angiography Emergent embolectomy Emergent embolectomy

Buerger disease Thromboangeiitis obliternt Thromboangeiitis obliternt Small and medium sized vessels are involved Small and medium sized vessels are involved Mostly in men under 40 Mostly in men under 40 Direct correlation wit cigarette smoking Direct correlation wit cigarette smoking Symptoms Symptoms biopsy biopsy treatment treatment

Atheroemboli Atheroemboli -a kind of acute arterial occlusion -a kind of acute arterial occlusion -preserved pulses -preserved pulses -blue toe -blue toe Arteriovenous fistula Arteriovenous fistula -congenital or acquired -congenital or acquired -may cause CHF -may cause CHF Nicoladoni-Branham sign Nicoladoni-Branham sign

Raynaud ’ s phenomena Paroxysmal digital ischemia Paroxysmal digital ischemia Primary or secondary Primary or secondary Pallor-cyanosis-rubor Pallor-cyanosis-rubor Sex and gender preferences Sex and gender preferences Normal peripheral pulses Normal peripheral pulses Clinical course Clinical course

Acrocyanosis Acrocyanosis Livedoreticularis Livedoreticularis Pernio Pernio Erhytromelalgia Erhytromelalgia frostbite frostbite

Venous disorders Venous thrombosis Venous thrombosis Virchow triad Virchow triad Deep vein thrombosis Deep vein thrombosis -etiology -etiology -symptoms and signs -symptoms and signs -Phelegmasia Cerula Dolens -Phelegmasia Cerula Dolens -Phelegmasia Alba Dolens -Phelegmasia Alba Dolens -diagnosis -diagnosis -treatment -treatment 1. anticoagulation 1. anticoagulation 2. conservative 2. conservative 3. thrombolytic therapy 3. thrombolytic therapy 4. interventions 4. interventions

Superficial thrombophlebitis Superficial thrombophlebitis Chronic venous insufficiency Chronic venous insufficiency -varicose veins -varicose veins Lymphatic disorders Lymphatic disorders -lymph edema -lymph edema