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Peripheral Vascular

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Introduction

Aortic aneurysm, as the name suggests, happens in the aorta. It is typically linked with the hardening of the arteries, also known as atherosclerosis. This condition may be inherited or a result of complications of high blood pressure or smoking. Aortic aneurysms are small bulges in the wall of the aorta or the artery, the major blood vessel that carries blood from the heart to the rest of the body. They occur when part of a blood vessel’s wall weakens and grows into an adjoining blood vessel, typically the abdominal aorta. A tear in this weakened area allows blood to escape from it. This is known as an aortic dissection. The most common location for an aortic aneurysm is at or near the top of the aorta (where it connects to other arteries). But they can also occur lower in the thorax, where there are fewer blood vessels. In general, if you have one, you have one, but they can be associated with other conditions such as Marfan syndrome, hypertension, and trauma.

What Causes Aortic Aneurysm?

A weakening of the aorta or aortic wall causes an aortic aneurysm. The most common causes are atherosclerosis and high blood pressure. This happens due to a combination of factors such as ageing, certain genetic disorders, certain drugs, or certain types of trauma. Aortic aneurysm is not the same as aortic stenosis, which is when there is constriction of the aorta due to the narrowing of the aortic wall. An aortic aneurysm can be classified by its level in the blood vessel into high, middle, and low categories. The risk of an aneurysm rising to a high category is higher in men than women. High-risk aneurysms are more likely to rupture than low-risk aneurysms.

Types of Aortic Aneurysms

Aortic aneurysms be classified by their size into small, medium, and large categories. The most severe threat of an aneurysm is that it can burst and cause a stroke or massive bleeding, which in either case is life-threatening. A large aneurysm can affect blood circulation leading to blood clots.

Symptoms of Severe Aortic Aneurysms

The symptoms can range from mild to severe, sometimes none at all. But some people are at higher risk of getting one, so routine examinations can help early detection of warning signs.

It’s important to see your doctor right away if you experience any of the following symptoms:

  • Sudden and tearing pain
  • Pulsating sensation
  • severe chest pain,
  • trouble breathing,
  • coughing up blood,
  • Lump near a blood vessel
  • a new bulge in your abdomen, or
  • a sudden change in your heart rate.
  • Aortic regurgitation, when the regurgitation of blood from the aorta causes backflow into the chest. This symptom can be mild or severe.
  • Aneurysm rupture can cause a person’s abdomen to swell or even to rupture severely, causing severe abdominal pain, tenderness, and swelling.

Diagnosis of Severe Aortic Aneurysms

Aneurysm is generally detected by an echocardiogram, which is a type of ultrasound that can reveal the size and shape of the aorta, and if an aneurysm is present. Blood tests can also show an increase in certain proteins that can be present if the aneurysm is large enough to cause blood loss. In a medical diagnosis, your doctor will ask questions on the following,

  • If there is a family history of heart disease
  • Complete physical examination of checking your blood pressure, feel the abdomen for a lump/mass
  • If your doctor suspects an aneurysm in the aorta, you will be asked to get an ultrasound test to measure the aneurysm.
  • If the doctor thinks the aneurysm is in the chest then a CT scan or an invasive test called an angiogram will be recommended.

Treatment of Severe Aortic Aneurysms

Treatment depends on the severity of the aneurysm. An aneurysm can be life-threatening if it ruptures. If you have an aortic aneurysm and it’s large enough to cause symptoms, treatment is aimed at reducing the size of the aneurysm and keeping the aorta open as much as possible. The aim of the treatment is to stop bleeding, reduce pain and preserve the remaining aorta. Sometimes, surgery is always not possible as it can be more dangerous than the aneurysm itself. Your doctor will examine the size, type, and location of the aneurysm and determine the best treatment,

  • Inoperable aneurysms – drugs will be prescribed to lower your blood pressure or ease the force of your heartbeats to reduce any chances of a rupture.
  • Operable aneurysms – your doctor will try medicines and monitor the progress of the condition. If the aneurysm gets dangerously large, then you may require surgery. In some cases, the aneurysm or section of the artery is removed and replaced with a synthetic graft.

The aneurysm repair aims to strengthen the aortic wall to prevent it from weakening again. An aneurysm repair is usually done under general anesthesia.

Prognosis of Severe Aortic Aneurysms

Generally, people with small aneurysms are not expected to have problems. Most people with aortic aneurysms are expected to have a normal lifespan and not experience any problems with their aorta. However, 10% to 15% of people will have an aneurysm that is large enough to cause significant symptoms, like significant pain or severe swelling. And 1% of people will have a rupture of the aneurysm.

Conclusion

As you now know, an aortic aneurysm is a condition in which part of your aorta – the major blood vessel that carries blood from your heart to your body – becomes enlarged. Call the doctor immediately if you think you may have an aneurysm because if that ruptures, it can be life-threatening. At best, to prevent an aortic aneurysm, you can control your blood pressure, and should you have a family history of heart disease or stroke, then bring changes to improve your health and lifestyle by exercising regularly, watching what you eat, and completely stopping smoking.

FAQS

What are the early symptoms of aortic aneurysm?

Early symptoms of aortic aneurysm include a pulsating feeling in your stomach and nagging back pain.

How serious is an aortic aneurysm?

The aorta is the largest blood vessel in the body which runs from the heart through the center of the chest and abdomen. Therefore, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.

Can a person survive an aortic aneurysm?

Some aortic aneurysms are hereditary or congenital, such as bicuspid aortic valve, infection, or inflammatory conditions. You can live with an aortic aneurysm. There are many ways to prevent dissection or a rupture with periodic examinations, medications, and interventions of healthy food and lifestyle.

What happens when you have an aortic aneurysm?

When you have an aortic aneurysm, there will be a bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the chest and tummy. This can get bigger over time and could burst (rupture), causing life-threatening bleeding.

What should you not do with an aortic aneurysm?

Your doctor will advise you to avoid heavy lifting and intense physical activities, which can increase blood pressure, putting additional pressure on your aneurysm.

Can you fully recover from an aortic aneurysm?

Typically, you will need 2 to 3 months to fully recover from an aortic aneurysm and be able to resume many of your usual activities after 4 to 6 weeks.

The Peripheral Vascular System is part of the body’s circulatory system which supplies to & receives blood from all parts of the body except Heart and Brain. The Peripheral Vascular system consists Peripheral Arteries which are responsible for oxygenated blood to get supplied from heart to all body parts, and Peripheral Veins carry deoxygenated blood from the extremities back to the heart.

What is peripheral vascular disease?

Peripheral Vascular Disease or PVD is a blood circulation disorder.

In this condition, your blood vessels narrow or get blocked or spasmed outside the heart and brain.

Peripheral vascular disease can happen in both arteries and veins throughout the body, but often affects the leg’s arteries the most causing fatigue particularly during exercise. This is called intermittent claudication.

One of the major causes of it is arteriosclerosis which is Plaque building up in a vessel and limiting blood flow and oxygen. As plaque build up progresses, it can reduce or completely block the blood flow in that artery leading to organ damage, loss of fingers, toes, etc.

This condition is different from Coronary Artery Disease and Cerebrovascular disease; these are when the narrowing happens in the heart or the brain respectively.

The Types of PVD

There are two types of Peripheral vascular disease: Functional and Organic

Functional PVD

Vessels widen and narrow in response to brain signals, temperatures changes, etc causing a decrease in the blood flow when vessels are narrowing.

 There is no physical damage to your blood vessels’ structure in functional PVD

The common causes of Functional PVD are emotional distress, colder temperatures, operating vibrating machinery or tools, drugs.

Organic PVD

This is caused due to Physical damage like plaque Built up, inflammation and more. There is damage to the physical blood vessels’ structure. The primary causes of Organic PVD are diabetes, high cholesterol levels, smoking and high blood pressure.

Risk factors

Some lifestyle factors majorly affect your body, hence putting you at a higher risk for PVD. For instance,

  • Overweight,
  • Age above 50,
  • History of stroke or cerebrovascular disease,
  • Abnormal cholesterol levels,
  • Family history of
    • High cholesterol
    • Heart disease,
    • Blood pressure
    • PVD
    • Kidney disease on hemodialysis.

Symptoms of Peripheral vascular disease

For majority, the first sign of PVD is fatigue and discomfort in your legs and feet, which gradually gets worse due to physical activity and lack of blood flow. This sign is rather slow and irregular but persistent.

The major symptom is Claudication. Claudication is lower limb muscle pain experienced while walking. You may notice the pain increasing when you walk long distances or faster and the pain subsides after some rest, but when the pain returns it takes some time to recede.

Other than the pain, some other symptoms also include

  • Reduced hair growth in the legs,
  • Cramps while lying in bed,
  • Arms or legs turning reddish-blue or even page,
  • Legs feeling thin,
  • Paler skin,
  • Weak pulses,
  • Wounds or ulcers that don’t heal,
  • Thick opaque toenails, and
  • Numbness and heaviness in the muscles.

If you’re experiencing these symptoms, do visit a doctor for a further look. More often than not these symptoms are disregarded as a sign of old age, but delayed diagnosis can lead to complications.

In extreme cases of blood loss, dead tissue can occur. If you suddenly develop a pale, cold limb with weak to no pulse, this is a medical emergency and you require treatment as soon as possible. Untreated limbs as such can lead to amputation.

Treatments for PVD

The treatments for PVD are directed to lower your risk of serious complications and manage your pain and symptoms helping you remain active.

 Major lifestyle modifications  – Initially treatment.

  • Regular balanced diet,
  • Exercise daily
  • Losing some weight.
  • Discontinuing Smoking as it directly causes the reduced blood flow in the vessels, and increases your risk of heart attack or stroke.

Medication

Prescribed by your doctor in order to treat the symptoms.

For instance, medications could be suggested to

  • Increase blood flow and relieve symptoms of leg pain
  • Reduced blood clotting,
  • Lowering high levels of cholesterol and for diabetes may be prescribed

Angioplasty or Vascular surgery

Intervention recommended in cases major artery blockages are diagnosed.

  • Angioplasty is when your doctor inserts a catheter into the artery and a balloon is inflated and open into the artery. In some other cases, a stent is used to keep the artery open.
  •  Vascular surgery, on the other hand, allows the blood to pass the narrow arteries through vein grafting.

If PVD is diagnosed in time, many cases will respond to lifestyle treatments. The best way to examine whether improvement has taken place is to see how far you can walk without pain.

Conclusion

 It is imperative to contact your doctor for a clear diagnosis if your legs look pale or blue to you if your legs become cold or you experience chest pain along with leg pain if you find new sores or ulcers have developed but they don’t heal, fever or any other sign of infections.