Vascular Disease – Acute Complications

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Introduction – Major cause of acute presentations to hospital.  Clinicians should be wary this as a cause in any patient with potential Vascular Risk Factors and presenting with acute pain

Pathology

  1. Atherosclerotic plaque rupture > Thrombus +/- embolus formation > acute arterial occlusion (more common)
  2. Small vessel rupture
  3. Chronic aneurysm formation > acute rupture

Examples

  • Brain – Stroke
  • Heart – Acute coronary syndrome’, myocardial infarction (acute chest pain)
  • Extremity – Acute Arterial occlusion (acute limb pain)
  • Gut – Mesenteric ischaemia/infarction (acute abdominal pain)
  • Abdominal aorta – Ruptured aortic aneurysm (acute abdominal/back pain)

Management Principles

  • Thrombus dissolution – anti-platelets, anti-coagulants, thrombolysis
  • Mechanical remove of thrombus – interventional radiology/angioplasty/stent, surgery
  • Vessel repair (if ruptured aneurysm)

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