Blutgefäße Archive | Cardiopraxis

A time bomb can tick in your stomach

Ärztlicher Beruf & Methoden, Blutgefäße, Notfall

An abdominal aortic aneurysm is a bulging of the aorta in the abdomen. It thus exceeds its maximum diameter of 3 cm. The abdominal aortic aneurysm is the most common aneurysm, with about 40 to 50 new cases per 100,000 people per year (more than 60% of all aneurysms).

Risk factors for this are:

male sex (6x more frequently than women)
Age > 65Years
smoking
high blood pressure
Arteriosclerosis in other vessels

Symptoms include back or abdominal pain, a pulsating feeling in the abdomen or a feeling of fullness after small meals. Often, however, the abdominal aortic aneurysm does not show any symptoms. It can be diagnosed by ultrasound, CT or MRT. Bleeding shock and even death can occur when an aneurysm bursts. With increasing size, the risk of this also increases.

From a diameter of more than 5.5 cm, occasionally even from 5 cm, an abdominal aortic aneurysm is treated open surgically or catheter-supported with a stent. This therapy is also used for particularly rapid growth (more than 10 mm per year).

Screening from the age of 65 is very important!

30. November 2018/von Dr. Stefan Dierkes

Ticking bomb in the chest: thoracic aortic aneurysm

Blutgefäße, Symptome

The so-called thoracic aortic aneurysm is a bulging of the aorta in the chest. 80% of cases are discovered by chance. With between 5 and 10 new cases per 100,000 inhabitants per year, the thoracic aortic aneurysm is much less common than the abdominal aortic aneurysm (40 to 50 cases per 100,000 per year). Predominantly men between the ages of 60 and 70 are affected.

Symptoms include:

shortness of breath
swallowing difficulties
chest and back pain

Causes for a thoracic aortic aneurysm can be:

high blood pressure
Connective tissue disease (e.g. Marfan syndrome)
Aortic valve disease (bicuspid valve)
arteritis

It is diagnosed by heart ultrasound, CT and MRT.

These complications may be associated with a thoracic aortic aneurysm:

rupture (= bursting open) – hardly survives
Dissection (= tear within the vessel wall) leads to acute circulatory disturbance of the brain, organs, arms and legs.
Risk increases with increase in aortic diameter

As a rule, operations are performed from a cross-section diameter of 55 mm. Early intervention is possible if risk factors such as a bicuspid aortic valve, a family predisposition to complications or a growth rate of 5 mm per year are present.

2. Juni 2018/von Dr. Natalie Fleissner

Leg vein thrombosis: How to recognise and treat it

Ärztlicher Beruf & Methoden, Blutgefäße

In leg vein thrombosis, the main veins are blocked by blood clots. A reliable diagnosis can only be made with special devices.

With compression sonography, an open vein can be fully compressed because the venous pressure is normally low. A thrombosed vein, on the other hand, cannot be compressed at all or only incompletely – after all, the pressure is increased here.

Leg vein thrombosis can be associated with various acute and chronic complications. For example, the proliferation of blood clots into the lungs can trigger pulmonary embolism. And in the so-called post-thrombotic syndrome, the venous valves are destroyed due to pressure, which leads to blood congestion and thus to „heavy legs“ or „open legs“.

Blood-thinning medication is used to treat leg vein thrombosis. Mostly they are used for 3 months, in case of repeated thromboses without recognizable triggers sometimes for life.

In the past, immobilization was considered sensible, but now doctors recommend the opposite: exercise activates the muscle pump and thus increases venous blood flow. To avoid post-thrombotic syndrome, patients should wear compression stockings for 2 years.

1. Dezember 2017/von Dr. Stefan Dierkes

Shop window disease: How to recognize and treat pAVK

Ärztlicher Beruf & Methoden, Blutgefäße

Peripheral arterial occlusive disease (PAOD) of the legs goes unnoticed for a long time. Symptoms are then load-dependent pain in the legs. The pAVK can be diagnosed by simple examinations.

This includes a physical examination with pulse keys and stethoscope. The so-called Doppler pen probe offers a high level of diagnostic reliability. This is how it works:

the systolic blood pressure is measured with cuff and double pin on leg and arm
the quotient of pressure on leg and arm = ankle/arm index is then determined
If the ankle/arm index is above 1.0, this is normal; a value below 0.9 is considered proof of pAVK.
this proof is possible even before symptoms appear

Further diagnostic procedures usually follow, for example:

Treadmill test to objectify the walking distance
color-coded ultrasound
Angio-MRI and angiography for therapy planning

In an initial diagnosis, the risk of frequent concomitant diseases is also assessed. For example, the risk of myocardial infarction using exercise ECG and heart ultrasound and the risk of stroke using ultrasound examination of the arteries supplying the brain.

27. Oktober 2017/von Dr. Natalie Fleissner

Vein thrombosis: Everything in the river in your legs?

Blutgefäße, Symptome

In deep leg vein thrombosis, the veins are blocked by local blood clots. In most cases, the areas of the legs and pelvis are affected, and arm vein thrombosis is much less common.

The so-called Virchow triad can explain how venous thrombosis develops: Blood flow, blood composition and certain vascular walls are disturbed.

are risk factors for leg vein thrombosis:

increasing age
Accident, plaster treatment, operations
congenital coagulation disorder
contraceptive pill
severe varicose veins
tumor disease
Overweight and smoking
long flights
dehydration

Seldom can thrombosis be explained by just one risk factor; often several factors come together, for example a long flight and dehydration.

The symptoms of leg vein thrombosis vary and are sometimes not noticed:

unilateral leg swelling
Reddening and overheating
aches
bluish discoloration
feeling of tension
increased superficial vein markings

6. Oktober 2017/von Dr. Stefan Dierkes

Heard of the window sickness?

Blutgefäße, Symptome

Peripheral arterial occlusive disease (PADD) is a chronic arterial circulatory disorder. Especially the pelvic leg arteries are affected.

Risk factors include:

age
smoking
diabetes mellitus
male gender
high blood pressure
cholesterol elevation

Symptoms only occur when a leg artery is constricted by more than 75% (stenosis). Behind the bottleneck there is a significant drop in blood pressure.

There are different stages of pAVK:

Stage I: structural changes without symptoms
Stage II: muscle pain after a certain walking distance, depending on the strain, forces the patient to stop again and again („shop window disease“).
Stage III: additional pain at rest
Stage IV: additional healing disorders in open wounds

The pavK is a so-called indicator disease. This means: As a rule, not only the arteries of the legs are constricted, but also the arteries that supply the brain and heart.

1. September 2017/von Dr. Natalie Fleissner