DISORDERS OF ARTERIES AND VEINSCZhhVg6]bZY!BVjgZZc9Vlhdc!8]g^hHb^i]:YLddY )%,
typically extends to the left shoulder and down the left arm. The inflammation
causes fluid and blood components, such as fibrin, erythrocytes and
leukocytes, to pour into the pericardial space. The inflammation may be
caused by a viral infection, in which case the condition may be painful but
short-lived and have no lasting effects, or result from a number of other
causes, for example cancer, heart attack, AIDS, kidney failure, heart surgery
and the side effects of certain drugs, some of which are life-threatening. The
treatment for acute pericarditis is to hospitalize the patient and treat with
antiinflammatory drugs, such as aspirin or ibuprofen that also reduce the
pain. Further treatment depends on the underlying cause. Individuals with
cancer that has invaded the pericardium rarely survive longer than 12–18
months.
The chronic form of the disease develops gradually and is long-lasting. Usually
the cause is unknown, but cancer and a reduced thyroid function have been
implicated.
14.16 Disorders of Arteries and Veins
A number of clinical disorders are associated with arteries and veins. These
include peripheral arterial disease, arterial aneurysms and dissections, strokes,
varicose veins and deep vein thromboses.
Peripheral Arterial Disease
Peripheral arterial disease can affect the abdominal aorta and its major
branches including the arteries to the legs. Obstruction can be sudden or
gradual. Most patients with peripheral arterial disease have atherosclerosis
that gradually narrows the arteries. Partial occlusion can also result from a
blood clot resulting in a sudden decrease in the oxygen supply. A sudden,
complete obstruction normally results from a clot lodging in a narrowed
artery. Emergency surgery or the use of thrombolytic drugs may be needed to
remove the obstruction.
Aneurysms
Ananeurysm is a round or tube-like bulge that usually develops in weak
areas of an arterial wall. There are many reasons for the development of
aneurysms, but high blood pressure and cigarette smoking increase the
risks. Also, a blood clot may form in the aneurysm. If an aneurysm occurs
in the aorta, an aortic aneurysm, rupture, hemorrhage and separation of
the layers of the wall (called dissection,see below) can occur with disastrous
results. Such conditions can be immediately fatal although most take years
to develop. Aortic aneurysm can develop anywhere along its length but
over 70% of them occur in the segment that run through the abdomen.
An individual with abdominal aortic aneurysm usually becomes aware of
a pulsing sensation in the abdomen, with a deep penetrating pain mainly
in the back. The aneurysm may rupture, with severe internal bleeding, and
the patient will typically go into severe shock (Section 14.17). Aortic rupture
is frequently fatal. The treatment of ruptured aneurysms involves surgical
repair, which is extremely risky. However, many patients are diagnosed early
during a routine examination, and then surgery to insert a synthetic graft can
be used to repair the aneurysm with a good chance of success.
Aortic Dissection
In an aortic dissection the inner lining of the vessel wall tears allowing blood to
surge through the tear, splitting the middle layer and creating a new channel.
The condition usually results from a deterioration of the arterial wall caused,