Peripheral Arterial Disease: Symptoms & Treatment Video

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  • 0:02 On the Periphery
  • 0:45 Aortic Dissection and Aneurysm
  • 4:04 Peripheral Arterial Disease
  • 5:45 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov
This lesson will discuss three main points, including aortic aneurysm, aortic dissection, and peripheral arterial disease. Furthermore, it will go into a big central cause for all three and how they can be detected and treated.

On the Periphery

As soon as I hear that something or someone is 'on the periphery' of something else, I tend to cringe, thinking it must be a bad thing or that someone isn't living up to their full potential.

However, when discussing peripheral vasculature, things like the arteries and veins in our legs and arms, then it's a completely different story. These guys are super important not only because they supply important muscles with oxygen but also because if they are diseased, they may be a sign of a more important or central problem in the body.

This lesson will discuss some diseases affecting a large central artery and those in the peripheries so you can appreciate how important both are in disease processes.

Aortic Dissection and Aneurysm

What I mean is, there's a disease process known as atherosclerosis that can affect the coronary arteries. These are the arteries that supply the blood with oxygen. If fatty accumulations called plaques build up within them (a condition called atherosclerosis), then this can lead to a heart attack.

Actually, atherosclerosis can also affect the largest artery in the body, known as the aorta. One problem atherosclerosis may predispose to is known as an aortic aneurysm. This refers to the dilation of the aorta greater than 50% of its normal diameter. This basically means that part of the aorta begins to balloon out like, of all things, a balloon as it expands.

This is not very good. It can keep ballooning out more and more, and, just like an overextended balloon, it can burst, leading to death.

Imaging tests such as an X-ray, CT scan, or ultrasound exam can help locate an aneurysm. Depending on how large the aneurysm is, it may either be medically managed or surgically repaired.

The other problem that atherosclerosis may lead to is known as an aortic dissection. This refers to the ripping apart of the tunica media of the aorta by way of blood entering through a tear in the tunica intima.

With that in mind, the aorta is made up of three layers. The inner layer that lines the arterial lumen, the open space where blood flows, is called the tunica intima. It's in 'intima'te contact with the blood. The middle layer of the aorta is the tunica media, with 'media' referring to the middle. And the 'externa'l layer is known as the tunica externa (aka tunica adventitia).

So, when the inner layer tears for any reason, blood enters into the tunica media. The force of the blood flow begins to separate or dissect the layers of the tunica media and actually forms what's known as a 'false lumen,' an empty space where blood is located within the tunica media. If this false lumen reconnects to the aorta at another point in the tear, it leads to the formation of what's known as a double-barreled aorta through which blood flows.

If it's hard to imagine what I'm talking about, then think of the aorta as an interstate highway. If you've even been on an interstate highway, then you most certainly have passed by rest stops on the right-hand side. The road leading to the rest stop is the initial tear of the tunica intima, the entire space of the rest stop itself is the false lumen, and because you can drive out of the rest stop and merge back into the aorta, this creates a double-barreled lumen through which blood can flow through (the other lumen being the original one of the aorta, the highway itself).

Chest or back pain may be indicative of an aortic dissection, but it's difficult to diagnose just based on that! That's why CT scans or an MRI help visualize the dissection. An aortic dissection can easily lead to death, and surgical repair is necessary to save a person's life. Medication that lowers blood pressure is also given so the tear doesn't get worse and the false lumen doesn't get any bigger.

Peripheral Arterial Disease

More at the periphery of the body, the arms and legs, a condition called peripheral arterial disease can occur. And if you didn't think it already, then you better believe atherosclerosis predisposes to this problem as well!

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