Vascular disease

What is vascular disease?

Vascular disease includes any condition that affects your circulatory or blood vessel system. These range from diseases of the arteries, veins and lymphatic vessels to blood disorders affecting the circulation.

Blood vessels are elastic-like tubes that carry blood to various parts of the body. Blood vessels include:

• Arteries that carry blood away from the heart.
• A vein that returns blood to the heart.
• Capillaries are your smallest blood vessels that connect your small veins and arteries, carrying oxygen and nutrients to your tissues and carrying away waste products from them.

Types of vascular disease

Some vascular diseases affect your arteries, while others occur in your veins. They may also occur only in specific parts of your body.

peripheral arterial disease

Just like your heart's blood vessels (coronary arteries), your peripheral arteries (the blood vessels outside your heart) can also develop atherosclerosis, a buildup of plaque (fat and cholesterol deposits) in them. Over time, the buildup can narrow the arteries. Eventually, narrowed arteries lead to reduced blood flow, which can lead to ischemia or insufficient blood flow to the body's tissues. Types of peripheral artery disease include:

• Peripheral Arterial Disease : Blockage in the legs. Complete loss of circulation can lead to gangrene and loss of limbs.
• Intestinal ischemic syndrome : Blockage of blood vessels leading to the gastrointestinal system.
• Renal artery disease : Blockage of the renal arteries can lead to renal artery disease and kidney failure.
• Popliteal syndrome : A rare vascular disease that affects the legs of some young athletes. Muscles and tendons near the knee compress the popliteal artery, restricting blood flow to the calf and possibly damaging the artery.
• Raynaud's phenomenon : Spasm of small arteries in the fingers and sometimes toes due to exposure to cold or stress.
• Buerger's disease : most commonly affects small and medium-sized arteries, veins, and nerves. Although the cause is unknown, it is closely related to tobacco use or exposure. Narrowing or blockage of the arteries in the arms and legs, resulting in insufficient blood supply (ischemia) to the fingers, hands, toes, and feet. In severe blockage, tissue may die (gangrene), making it necessary to amputate the affected fingers and toes. Superficial vein inflammation and Raynaud's symptoms may also occur.

carotid artery problems

These occur in the two main carotid arteries in the neck.

• Carotid artery disease : Blockage or narrowing of the arteries that supply the brain. This can lead to a transient ischemic attack (TIA) or stroke.
• Carotid artery dissection : starts with a tear in one layer of the artery wall. Blood leaks through this tear and spreads between the wall layers.
• Carotid body tumor : A growth in the nerve tissue surrounding the carotid arteries.
• Carotid aneurysm : A bulge in the wall of an artery that weakens the wall and may lead to rupture.

venous disease

Veins are flexible, hollow tubes with valves inside, called valves. When your muscles contract, these one-way valves open and blood flows through your veins. When your muscles relax, the valves close, allowing blood to flow in one direction through your veins.

If a valve within a vein is damaged, the valve may not close completely. This allows blood to flow in both directions. When your muscles relax, the valves in the damaged veins can no longer hold blood. This may lead to pooling of blood or swelling of the veins. The veins are bulging and look like cords under the skin. Blood begins to move slowly through your veins and may stick to the sides of the vessel walls. Symptoms include heaviness, pain, swelling, throbbing, or itching. Blood clots can form.

• Varicose veins : Swollen, purple, rough veins visible under your skin. Damaged valves within the veins can cause this condition.
• Spider veins : Small red or purple dots that appear on your knees, calves, or thighs. Swollen capillaries (small blood vessels) can cause this condition.
• Klippel-Trenaunay syndrome (KTS) : A rare congenital (present at birth) blood vessel disorder.
• May-Thurner syndrome (MTS) : The right iliac artery compresses the left iliac vein, which increases the risk of deep vein thrombosis (DVT) in the left extremity.
• Thoracic outlet syndrome (TOS) : A group of disorders that occur due to pressure, damage, or irritation of nerves and/or blood vessels (arteries and veins) in the neck, armpits, and upper chest areas.
• Chronic venous insufficiency (CVI) : A condition that occurs when the vein walls and/or valves in the leg veins do not work effectively, making it difficult for blood to return from the legs to the heart.

blood clot

Clots form when clotting factors in the blood cause it to clot, or turn into a solid, jelly-like substance. When a blood clot (thrombus) forms in a blood vessel, it can break loose and travel through your bloodstream, causing deep vein thrombosis, pulmonary embolism, heart attack , or stroke.

Blood clots in the arteries can increase the risk of stroke, heart attack, severe leg pain, difficulty walking, and even loss of a limb.

• Hypercoagulability or coagulopathy : Conditions that put people at increased risk of blood clots because they make the blood more likely to form clots in arteries and veins (hypercoagulability). You can inherit or acquire these conditions (congenital, occurring at birth). These disorders include insufficient levels of factors in the blood that cause blood clotting (fibrinogen, factor 8, prothrombin) or natural anticoagulant (blood-thinning) proteins (antithrombin, protein C, protein S). The most aggressive disease involves circulating antiphospholipid antibodies, which can lead to arterial and venous thrombosis.
• Deep vein thrombosis (DVT) : A blood clot that occurs in a deep vein.
• Pulmonary embolism : A blood clot that breaks off from a vein and travels to the lungs.
• Axillary subclavian vein thrombosis , also known as Paget-Schroeder syndrome : The most common vascular disease affecting young, competitive athletes. This condition occurs when your collarbone (clavicle), first rib, or surrounding muscles press on a vein in your armpit (armpit) or in front of your shoulder (subclavian vein). This increases the risk of blood clots.
• Superficial thrombophlebitis : Blood clots in veins under the skin.

aortic aneurysm

An aneurysm is an abnormal bulge in the wall of a blood vessel. Aneurysms can form in any blood vessel, but they are most common in the aorta (aortic aneurysm), which is the main blood vessel leaving the heart:

• Thoracic aortic aneurysm.
• Abdominal aortic aneurysm.

Fibrofibrous dysplasia (FMD)

Fibromuscular dysplasia (FMD): A rare disease in which people have abnormal growth of cells in the walls of their medium and large arteries. This can cause abnormally growing arteries to look like beads on a string and become narrowed. This can lead to problems with the arteries, including aneurysms and dissections.

Lymphedema

The lymphatic system includes an extensive network of lymphatic vessels and lymph nodes that help coordinate the functions of your immune system to protect your body from foreign substances. Lymphedema is an abnormal accumulation of fluid when lymphatic vessels or lymph nodes are missing, damaged, compromised, or removed.

• Primary lymphedema (rare): Some people are born without or with abnormalities in certain lymphatic vessels.
• Secondary lymphedema : Occurs due to blockage or disruption of the lymphatic system. Causes include infection, malignancy, surgery, scar tissue formation, trauma, deep vein thrombosis (DVT), radiation or other cancer treatments.

Vasculitis

Your blood vessels may become inflamed due to medications, infection, or unknown causes. This makes it difficult for blood to move through the blood vessels. This is sometimes associated with rheumatism or connective tissue disease. Vasculitis can also cause aneurysms.

Who does vascular disease affect?

Some people are born with blood vessel disease inherited from their parents. In these conditions, such as clotting disorders, they start dealing with the problem at a young age. However, many blood vessel diseases, such as peripheral artery disease or carotid artery disease, develop over time due to the accumulation of plaque (fat and cholesterol) in the arteries. Atherosclerosis, the hardening of the arteries, can start in your teens and cause problems in midlife or later.

How common is vascular disease?

Vascular disease is very common in the United States, in part because so many people are overweight and have diabetes. The most common vascular diseases include peripheral artery disease (PAD) and carotid artery disease.

What are the symptoms of vascular disease?

Symptoms vary depending on the type of vascular disease.

peripheral artery disease symptoms

• Peripheral artery disease: pain or cramping in the legs with activity but improvement with rest; changes in skin color; sores or ulcers and tired legs.
• Intestinal ischemia (or mesenteric ischemia) syndrome: Severe stomach pain, nausea, vomiting, diarrhea, food phobia, and weight loss.
• Renal artery disease: Uncontrolled high blood pressure (hypertension), congestive heart failure, and abnormal kidney function.
• Popliteal syndrome: Cramps, numbness, tingling, and discoloration of the legs and feet.
• Raynaud's phenomenon: Fingers and toes that appear red, blue, or white, throbbing, tingling, and red.
• Buerger's disease: Pain in the arms, hands, legs, and feet, even at rest. Blue or pale fingers or toes.

Symptoms of carotid artery problems

• Carotid artery disease: Often there are no symptoms before a stroke or transient ischemic attack (TIA or mini-stroke). These symptoms include vision or speech difficulties, confusion, and memory difficulties.
• Carotid artery dissection: headache, neck pain, and eye or facial pain.
• Carotid body tumor: Heart palpitations, high blood pressure, sweating, and headache.
• Carotid aneurysm: Stroke or transient ischemic attack (TIA or mini-stroke).

venous disease symptoms

• Varicose veins and spider veins: Swelling, pain, blue or red veins visible in the legs.
• Klippel-Trenaunay syndrome (KTS): Pain or heaviness in the legs or arms.
• May-Thurner syndrome (MTS): Swelling, tenderness, leg pain, redness or discoloration of the skin.
• Thoracic outlet syndrome (TOS): Neck, arm, and shoulder pain, tingling, and numbness in the arms or hands.
• Chronic venous insufficiency (CVI): leg cramps, leg heaviness or pain, leg swelling or pain.

blood clot

• Coagulation disorders: deep vein thrombosis, pulmonary embolism.
• Deep vein thrombosis (DVT): leg pain, swelling, warmth, and red skin.
• Pulmonary embolism: coughing up blood, chest pain, shortness of breath.
• Axillary-subclavian vein thrombosis: Swelling, heaviness, or pain in the arms or hands, and the skin may appear blue.
• Superficial thrombophlebitis: inflammation, pain, heat around the veins, redness of the skin.

aortic aneurysm symptoms

• Thoracic aortic aneurysm: chest pain, increased heart rate, difficulty swallowing, and neck swelling.
• Abdominal aortic aneurysm: Abdominal or back pain, dizziness, nausea and vomiting, rapid heart rate (if the aneurysm ruptures).

Fibrofibrous dysplasia (FMD) symptoms

Fibromuscular dysplasia (FMD): Neck pain, vision changes, high blood pressure, dizziness, hearing a "whooshing feeling" or hearing your heartbeat in your ears.

lymphedema symptoms

Swelling, most commonly in your arms or legs.

Vasculitis Symptoms

Feeling sick, having a fever, swelling.

What causes vascular disease?

For some blood vessel problems, the cause is unknown. Causes of vascular disease include:

• High cholesterol.
• hypertension.
• Smoking or using tobacco products.
• diabetes.
• The genes you get from your parents.
• drug.
• Injuried.
• Infect.
• Blood clots.

How is vascular disease diagnosed?

Your healthcare provider will want to perform a physical exam and obtain your medical history, as well as a history of any diseases that run in your family. It can help your healthcare provider look for blood vessel disease when you take off your shoes and socks before examining you.

Depending on the type of vascular disease your provider suspects, they may order blood tests and imaging.

What tests will be performed to diagnose vasculopathy?

Many vascular diseases involve clots or blockages in blood vessels. To diagnose these, your healthcare provider needs to be able to see inside your blood vessels using imaging methods, including:

• Vascular ultrasound.
• Catheter angiography.
• CT angiography.
• Magnetic resonance angiography.

How are vascular diseases treated?

Eating healthier and exercising more can help treat many vascular diseases. For others, you may need to take medication or have surgery. Treatment for vascular disease varies depending on the condition.

Peripheral Arterial Disease Treatment

• Peripheral artery disease: diet, exercise, medications, surgery.
• Intestinal ischemic syndrome: painkillers, clot-busting drugs, surgery to remove clots. Angioplasty, stent placement or bypass surgery in chronic cases.
• Renal artery disease: A low-salt, heart-healthy diet. High blood pressure drugs, statins.
• Popliteal artery entrapment syndrome: Surgery to release the popliteal artery.
• Raynaud's Phenomenon: Keep your hands and feet warm. Take medicines that help blood vessels stay open (dilate).
• Buerger's disease: Quit smoking. Warm up fingers and toes. Taking medicines (vasodilators) to open the blood vessels.

Treatment of Carotid Artery Problems

• Carotid artery disease: A healthier diet. Blood thinners and cholesterol-lowering drugs. Plaque removal (carotid endarterectomy). Angioplasty and stenting to keep arteries open.
• Carotid artery dissection: antiplatelets, anticoagulants, stents.
• Carotid body tumor: Surgery to remove the tumor.
• Carotid aneurysm: antihypertensive drugs, cholesterol-lowering drugs, clot-busting drugs. Bypass or stent graft surgery.

Vein disease treatment

• Varicose veins and spider veins: removed using heat, saline or laser therapy.
• Klippel-Trenaunay syndrome (KTS): Same treatment as varicose veins.
• May-Thurner syndrome (MTS): Same as deep vein thrombosis.
• Thoracic outlet syndrome (TOS): Physical therapy, medicine.
• Chronic venous insufficiency (CVI): Move your legs frequently and wear compression stockings. The vein is removed with saline, laser, or through an incision.

Thrombosis treatment

• Coagulopathy: Same as deep vein thrombosis and pulmonary embolism.
• Deep vein thrombosis (DVT): Elevate your legs. Take blood thinners and painkillers.
• Pulmonary embolism: blood thinners and thrombolytics. Procedure for removing clots.
• Axillary subclavian vein thrombosis: thrombolytics, blood thinners. Remove the clot.
• Superficial thrombophlebitis: Elevate the affected limb above the heart. Use hot compresses. Wear support stockings. Surgery to remove the vein.

aortic aneurysm treatment

• Thoracic aortic aneurysm: Surgery to insert a fabric graft or stent. This can be a major surgery, depending on the location and method of surgery.
• Abdominal aortic aneurysm: Surgery to place a graft. Endovascular repair is less invasive.

Fibrofibrous dysplasia (FMD)

• Blood thinners, painkillers.
• Angioplasty. Surgery to prevent arteries from rupturing.

Lymphedema

• Lie down with your arms above your heart level for 45 minutes twice a day.
• Wear compression sleeves.
• Use the affected limb for daily tasks.
• If recommended by your healthcare provider, visit a specialized lymphedema clinic.

Vasculitis

• Your provider may prescribe medications such as steroids.

Complications/Side Effects of Treatment

Any drug can have side effects, but the benefits of the drugs usually make them worth taking. Side effects usually go away. If they don't, you can ask your healthcare provider to switch you to another medicine.

When considering a procedure or surgery, discuss the risks and benefits with your provider. What works for your neighbor may not work for you.

How can you reduce your risk of vascular disease?

You can't do anything about your age, family history, or genes, but you can:

• Manage your diabetes, high cholesterol and high blood pressure.
• Exercise regularly.
• Eat healthier foods.
• If you have to sit or stand for several hours, move every hour.
• Maintain a healthy weight.
• Lower your stress levels.
• Avoid tobacco products.

What can I expect if I have vascular disease?

Vascular disease can be a lifelong problem. Once your healthcare provider knows you have plaque buildup in your blood vessels, they will want you to make some changes to your lifestyle. These changes, such as exercising, not using tobacco products, and making healthier food choices, are things you will need to continue doing for years to come. You may also need to take medications to reduce your risk of heart attack or stroke.

Outlook for this situation

The outlook for many vascular diseases is good if your healthcare provider catches the problem early. Many blood vessel problems become more difficult to treat as the condition worsens. Some vascular diseases, such as carotid dissection, abdominal aortic aneurysm, and pulmonary embolism, can be life-threatening.

How do I take care of myself?

In addition to the things mentioned above, you will need to continue taking the medications prescribed by your healthcare provider and continue to have regular check-ups.

When should I see my health care provider?

Contact your provider if you have any changes in your blood vessel problems or if you have any questions about the medications they prescribe.

When should I go to the emergency room?

• Confusion or dizziness.
• Speech is unclear.
• One side of the face droops.
• Severe chest pain.
• Severe abdominal pain.
• Loss of vision.
• Weakness in the arms or legs.

What questions should I ask my doctor?

• What is the best treatment for my specific situation?
• Is there anything else I should do to take care of my vascular condition?
• Is there anything related to this vascular problem that I should be aware of?

The best thing you can do for vascular disease is to remain vigilant. Do not skip any physical exams or medication doses. Since some vascular problems run in families, sharing health information with family members can help them prevent and be aware of vascular disease. Encourage your family to check their blood pressure and cholesterol, as high levels can put them at risk for blood vessel disease.