Vascular System
Vasodilators
| Mechanism | Medication |
|---|---|
| K channel activators | Minoxidil Diazoxide |
| Ca channel blockers | -Dipines |
| α1 antagonists | Terazosin Doxazosin Prazosin |
| α2 agonists | Methyldopa Clonidine Guanfacine |
| D1 agonists | Fenoldopam |
| A1 agonists | Adenosine |
| ETA antagonists | Bosentan |
| PDE inhibitors | Dipyridamole Cilostazol |
| Nitrates | Nitroprusside Hydralazine |
Venodilators
| Mechanism | Medication |
|---|---|
| μ-opioid agonists | Morphine |
| Nitrates | Nitroglycerin Isosorbide |
Indications for Repair of Abdominal Aortic Aneurysm (AAA)
- > 5.5 cm in men
> 5.0 cm in women - > 1 cm/year
- Symptomatic AAA
Thromboembolic Diseases
Arterial Thromboembolism
- Coronary artery disease (CAD)
- Carotid artery stenosis (CAS)
- Renal artery stenosis (RAS)
- Peripheral artery disease (PAD)
- Chronic limb ischemia (CLI)
- Acute limb ischemia (ALI)
- Intestinal ischemia (II)
- Ischemic stroke (IS)
Venous Thromboembolism
- Pulmonary embolism (PE)
- Deep vein thrombosis (DVT)
- Cavernous sinus thrombosis (CST)
- Hepatic vein thrombosis
Revascularization Techniques
| Technique | General Indications | Indications |
|---|---|---|
| Thrombolysis | Venous thromboembolism Arterial embolism | PE & DVT & CST & CAD & ALI & II & IS |
| Thrombectomy | Venous thromboembolism Arterial embolism | PE & DVT & CST & CAS & ALI & II & IS |
| Angioplasty | Arterial thrombosis | CAD & CAS & RAS & CLI & II |
| Bypass surgery | Arterial thrombosis | CAD & CAS & RAS & CLI & II |
Fontaine Staging of Peripheral Artery Disease (PAD)
| Stage | Symptoms |
|---|---|
| 1 | Asymptomatic |
| 2 | Intermittent claudication |
| 3 | Ischemic rest pain |
| 4 | Ulceration & Gangrene |
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Treatment of Peripheral Artery Disease (PAD)
- Antiplatelets
- Aspirin
- ADP antagonists
- Anticoagulants :: Heparin
- Statins
- Supervised exercise therapy
- PDE inhibitors :: Cilostazol
- Revascularization
- Percutaneous transluminal angioplasty (PTA)
- Arterial bypass surgery
Vasculitis
Large-vessel
- Takayasu arteritis
- Giant cell arteritis [Temporal arteritis]
Medium-vessel
- Kawasaki disease
- Polyarteritis nodosa
- Thromboangiitis obliterans [Buerger disease]
Small-vessel
- ANCA-associated vasculitis (AAV)
- IgA vasculitis [Henoch-Schonlein purpura (HSP)]
- Cryoglobulinemic vasculitis
ANCA-associated vasculitis (AAV)
| Vasculitis | Antibodies | Affected Organs |
|---|---|---|
| Granulomatosis with polyangiitis (GPA) [Wegener granulomatosis] | PR3-ANCA [c-ANCA] | Nasopharynx & Sinus & Lung & Kidney |
| Eosinophilic granulomatosis with polyangiitis (EGPA) [Churg-Strauss syndrome] | MPO-ANCA [p-ANCA] | Sinus & Asthma & Kidney & Nerve |
| Microscopic polyangiitis | MPO-ANCA [p-ANCA] | Lung & Kidney |
Presentation of Kawasaki Disease {F-SCARE}
- Fever :: > 40°C for > 5 days
- Strawberry tongue
- Conjunctivitis
- Adenopathy :: neck
- Rashes :: desquamating
- Edema :: limbs
Presentation of Hereditary Hemorrhagic Telangiectasia (HHT) [Osler-Weber-Rendu Syndrome]
- Telangiectasia
- Epistaxis
- Arteriovenous malformation (AVM)
- Cerebral AVM
- Pulmonary AVM
- Paradoxical embolism