1. Arterial Diseases
   1. Dyslipidemia
      1. Atherosclerosis
         1. Leads to CAD, MI, Stroke, PVD
         2. Forms Fibrofatty Lesions
         3. Risks: High LDL, low HDL, Age >45 men, cig smoking, family history, HTN, diabetes, obesity, stress
         4. Fours Steps for Formation
            1. Endothelial Cell Injury
            2. Dysfunctional, dont produce:
            3. Nitric oxide
            4. Prostocyclin
            5. Migrations of Inflammatory Cells
            6. They also injure vascular endothelium
            7. LDL Oxidation
            8. Foam Cells
            9. Plaque Formation
            10. Necrotic Core
         5. Effects
            1. Myocardial Ischemia
            2. Weakening of BV walls- aneurysm, stroke
            3. PVD
      2. Lipoproteins
         1. Process of LDL and HDL
      3. Causes:
         1. Diet, obesity, family history, age, drugs, alcohol, OC, diseases
         2. Familial Hypercholesterolemia
            1. Lack of:
            2. LDL Receptors
            3. Apoprotein
            4. Leads of Xanthomas
      4. Management
         1. Diet, weight loss, smoking, exercise, control BS
         2. Drug Therapy
            1. Statins
            2. HMG CoA Reductase
            3. Ezetimibe
            4. Decreases Chylomicron Production
            5. Bile Acid Sequestrants
            6. Bile in Feces
   2. Aneurysm
      1. Highest probably: Aorta and Heart Walls after M.I.
      2. Causes:
         1. Atherosclerosis
         2. HTN
         3. Marfans Syndrome
      3. Types:
         1. True Aneurysm( all three layers affected)
            1. Fusiform Circumferential
            2. Fusiform Saccular (Berry)
         2. False Aneurysm
            1. Blood Clot
         3. Dissecting Aneurysm
            1. Cut in the wall of vessel contained by conn. tissue
         4. Thoracic Aneurysm
            1. More Symptoms bc of tight cavity
            2. Neck, back shoulder pain
            3. Dysphagia, dyspnea
         5. Abdominal Aneurysm
            1. Impaired blood flow/return
            2. Less symptoms bc loose intestines
         6. Cerebral Aneurysm
            1. Headache, more cranial presure
      4. Manifestations
         1. Asymptomatic
         2. Body compensates: Low CO
      5. Treatments:
         1. Reduce BP
            1. Maintain BV, good diet
         2. Stop Smoking
         3. Surgical Repair
            1. Grafting/ wrapping
         4. Dissecting
            1. Clipping/coiling
   3. Inflamm. Diseases
      1. Vasculitis
         1. Polyarteritis Nodosa
            1. inflammation nodes in small/med. vessels
            2. Cause: Unknown
            3. Drug abusers meth, cocaine, heroin
            4. Symptoms: Abrupt onset, anorexia, weight loss, NVD, organ effect
            5. Treatment:
            6. Corticosteriods
            7. Immunosuppresion
         2. Giant Cell (Temporal) Arteritis
            1. Most common and most in elderly
            2. Cause: Unknown....autoimmune
            3. Effects large arteries branching off the aortic arch
            4. Opthalmic, Temporal, Vertebral
            5. Multinucleated Giant Cells
            6. Manifestations
            7. HA
            8. Blurred Vision
            9. 10% Aortic Aneurysm
            10. 50% Polymyalgia
            11. muscle pain, join and deep pain
            12. Treatment:
            13. High Dose Corticosteriods
         3. Thromboangiitis Obliterans(Buerger Disease)
            1. Occurs in young "heavy smokers" men
            2. Inflammation of peripheral arteries
            3. vasospasm
            4. thrombus formation
            5. obliterate function of small/medium arteries
            6. Cause: Unknown
            7. Manifestations:
            8. pain, tenderness
            9. sluggish blood flow
            10. Ischemia, hypoxia
            11. skin and nails"thin"
            12. gangrene if severe.
            13. Txt:
            14. stop smoking
            15. vasodilators
            16. corticosteriods
   4. Raynauds Diseases/Phenomenon
      1. uncontrolled vasospasm of small arteries in extremities
      2. Phenomenon: worst type and damage to nerves around injuries
      3. Disease: occurs in healthy young women exposed to stress/cold
         1. Possible Cause: overactivation of SNS
         2. Vasoplastic angina- in healthy indivi. exposed to cold/stress
      4. Manifestations:
         1. numbness, tingling
         2. ischemia, cyanosis, rubor
         3. brittle skins and nails, gangrene/ulcer if severe
      5. Txt:
         1. Vasodilators
         2. Sympathetic Denervation
         3. CCB, Alpha Blocker
         4. Avoid: stress/cold
2. Venous Diseases
   1. Venous Thrombosis
      1. Thrombus
         1. Blood clot caused by:
            1. Injury, surgery
            2. Stasis of blood, immobility
            3. Hypercoaguability, atherosclero.
      2. Embolism: traveling clot
         1. Common Causes:
            1. Thrombus, bacteria
            2. Fat, air, ccells
      3. DVT (more common and dangerous)
         1. asymptomatic but visible
         2. swelling, edema, pain
         3. Txt:
            1. Thrombolytics
            2. Anti-coag.
         4. Can be prevented by:
            1. Vitamin K
            2. Warfarin
            3. Aspirin
   2. Varicose Veins
      1. Effects large veins of leg
      2. causes:
         1. Prolonged standing (pharm.)
         2. pregnancy
         3. obesity
      3. Manifestations
         1. Painful, unsightly
         2. Swelling, edema
         3. Not serious but could lead to chronic venous insuff.(dangerous)
   3. Chronic Venous Insufficiency
      1. Failure of "venous valves" to close
      2. competent valves are vital for movement of blood
      3. Causes:
         1. Patients with longterm pull
         2. chronic distention of veins
         3. Trauma to valves
      4. Manifestations:
         1. Change to tissue:
            1. Ischemia, accum. of wastes, hypoxia
         2. Statis Dermatitis and Ulcers
         3. Marked Edema on feet
         4. Poor Healing
      5. Txt:
         1. Elastic Stockings
         2. Avoid Standing, elevate feet
         3. surgery
            1. cosmetic for varicose veins