Vascular disease

Vascular disease
Veins and arteries
Classification and external resources
Specialty	angiology
ICD-10	G45-G46, I60-I95
ICD-9-CM	325, 430-459
MeSH	D014652

Vascular disease is a class of diseases of the blood vessels – the arteries and veins of the circulatory system of the body. It is a subgroup of cardiovascular disease. Disorders in this vast network of blood vessels, can cause a range of health problems which can be severe or prove fatal.^[1]

Associated medical conditions

Types

There are several types of vascular disease, (which is a subgroup of cardiovascular disease), the signs and symptoms depend on which type, among them are:^[2]

• Erythromelalgia - a rare peripheral vascular disease where syndromes includes burning pain, increased temperature, erythema and swelling, of mainly the hands and feet are affected.
  

  Erythromelalgia in a 77-year-old woman
• Peripheral artery disease – happens when atheromatous plaques build up in the arteries that supply blood to the arms and legs, plaque causes the arteries to narrow or become blocked.^[3]
• Renal artery stenosis - is the narrowing of renal arteries that carry blood to the kidneys from the aorta.^[4]
• Buerger's disease – is due to small blood vessels that inflame and swell, vessels then narrow or are blocked by blood clots.^[5]
• Raynaud's disease – a rare peripheral vascular disorder of constriction of the peripheral blood vessels, in the fingers and toes when the person is cold.^[6]
• Disseminated intravascular coagulation – a widespread activation of clotting in the smaller blood vessels.^[7]
• Cerebrovascular disease–a group of vascular diseases that affect brain function.

Mechanism

Endothelium lines the inner wall of the vessel

Vascular disease is a pathological state of large and medium muscular arteries and is triggered by endothelial cell dysfunction.^[8] Because of factors like pathogens, oxidized LDL particles and other inflammatory stimuli endothelial cells become active.^[9] The process causes thickening of the vessel wall, forming a plaque that consists of proliferating smooth muscle cells, macrophages and lymphocytes.^[10][11] The plaque results in a restricted blood flow which will decrease the amount of oxygen and nutrients that reach certain organs,^[12] the plaque might rupture causing the formation of clots.

Diagnosis

It can be difficult to make a Vascular disease diagnosis since there are a variety of symptoms that a person can have, also family history and a physical examination are important. The physical exam may be different depending on the type of vascular disease. In the case of a peripheral vascular disease the physical exam consists in checking the blood flow in the legs.^[13][14]

Treatment

Peripheral vascular disease-ulcer

Treatment varies with the type of vascular disease; in the case of renal artery disease, information from a meta-analysis indicated that balloon angioplasty results in improvement of diastolic blood pressure and a reduction in antihypertensive drug requirements.^[15] In the case of peripheral artery disease, preventing complications is important; without treatment, sores or gangrene (tissue death) may occur. Among the treatments are:^[16]

• Quitting smoking
• Lowering cholesterol
• Lower blood pressure
• Lower blood glucose
• Physical activity

References

Further reading

• "The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials". www.crd.york.ac.uk. Retrieved 2015-06-23.