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Vascular Disease

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Ascending Aneurysm / Dissection

When a sack-like dilation forms in the wall of a damaged or weakened artery, it is called an aneurysm. Aneurysms can form on any arterial wall that has deteriorated over time because of high blood pressure, a hardening or narrowing of the arteries or other contributing factors. Ascending aneurysms involve the aortic valve and the major arteries leading to the head and arms. If the aneurysm ruptures or tears (known as dissection), it can be fatal unless emergency surgery is performed quickly.Symptoms can include: Shortness of breath, dry cough, hoarseness and a pulsating pain in the chest or head. Other symptoms are specific to the location and type of aneurysm.

Descending Aneurysm / Dissection 

Most aneurysms of the aorta involve the abdominal aorta and usually begin at or below the level of the renal arteries.  A sack-like bulge forms in the weakened area.  When blood leaks through the weakened wall a rupture has occurred.  It is important to repair aneurysms before they rupture.  Survival is more than four times more likely when an aneurysm is repaired prior to rupture of the aneurysm.  Aneurysms less than five centimeters in diameter rarely rupture.Aneurysms of the descending thoracic aorta are less common than abdominal aortic aneurysms but are equally dangerous.  Some descending thoracic aortic aneurysms are due to a weakened aortic wall like the abdominal aortic aneurysm.  Others are caused by a tear in the inner layer of the aorta allowing blood to burrow up and down the aortic wall weakening the wall of the aorta.  This is called an aortic dissection.  If blood leaks through the entire aortic wall into surrounding tissues a rupture has occurred.Most aneurysms are not symptomatic.  Most are discovered incidentally on a physician’s examination or an ultrasound or CT scan ordered for other reasons.  Medicare now will pay for a one time screening ultrasound of the abdominal aorta in men 65 and older.  Non-ruptured aneurysms may cause back or abdominal pain.  A dissecting descending thoracic aneurysm classically causes severe tearing pain between the shoulder blades and back pain.

Coronary Heart Disease 

Coronary artery disease develops slowly, usually over a period of decades. Plaque, which is composed of fat, cholesterol, calcium and other substances, builds up on the artery walls over time. Coronary artery disease can be hereditary, or it can develop over time from a poor diet and lack of exercise. Eventually the flow of blood becomes severely restricted, causing shortness of breath and chest pain. When the artery becomes completely blocked, a heart attack can occur.Symptoms can include: chest pain or pressure (angina), which feels as if someone is standing on your chest, shortness of breath or a heart attack. Symptoms of a heart attack typically include a crushing pressure on your chest, pain in your shoulder or arm and in women, nausea and back or jaw pain. However, a heart attack may occur without any symptoms at all in cases of coronary artery disease, especially when it is associated with diabetes.

Renal Vascular Disease 

The arteries supplying blood to your kidneys are called the renal arteries.  Renal vascular disease occurs when the renal arteries become narrow or obstructed.  When blood flow to the kidney is restricted the kidney may release increased amounts of a powerful hormone called renin.  This may cause a particularly severe form of hypertension which can cause heart failure or stroke. Renal vascular disease may also cause kidney failure resulting in the need for hemodialysis.There are often no symptoms of renal vascular disease until late.  Symptoms may include headache or blood in the urine. The abrupt onset of hypertension or hypertension that is difficult to control and requires multiple drugs suggests renal vascular disease.  The loss of kidney function or sudden onset of heart failure may also be the result of renal vascular disease.

Legs / Peripheal Vascular Disease 

What is Peripheral Arterial Disease? Peripheral Arterial Disease (PAD) is a common, yet serious, vascular disease that affects more than eight million people in the United States. It occurs when extra cholesterol and other fats circulating in the blood collect in the walls of the arteries that supply blood to your limbs. This buildup – called plaque – narrows your arteries, often reducing or blocking the flow of blood. PAD is most commonly seen in the legs, but can also be present in the arteries that carry blood from your heart to your head, arms, kidneys and stomach. Many individuals with PAD suffer from an inability to walk as far or as fast as they could in the past. This can become lifestyle-limiting, and even debilitating. People who have PAD are more likely to have foot problems. Minor foot injuries can cause sores or ulcers that can turn into serious infections. If these sores are not treated right away, they may lead to losing a toe, foot or leg. In fact, PAD is one of the leading causes of foot or leg amputations in the United States. Finding and treating PAD early can help keep your legs healthy, lower your risk for heart attack or stroke, and save your life and limbs.

High Blood Pressure 

Often called the “silent killer” because it can go undetected for years, high blood pressure afflicts 1 in 3 adults in the United States. Blood pressure is the force exerted by your blood on the artery walls. If it is consistently too high, it can lead to coronary heart disease, aneurysms, stroke, heart failure, kidney failure and other health problems.Symptoms can include: Though there often are no discernable symptoms, but some people with high blood pressure experience headaches, dizziness, blurred vision and nausea. The only true way to diagnose high blood pressure is through a blood pressure test.

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