1. Blood Vessels Frank A. Acevedo, PA-C

2. Vascular Abnormalities Narrowing of the lumen Thrombosis Weakening of the walls

3. Normal Intima - Endothelial Cells Media - Smooth Muscle Cells Adventitia - Connective Tissue

4. Arteries Elastic arteries Muscular arteries Arterioles

5. Endothelium Anticoagulant/Antithrombotic prostacyclin, thrombomodulin, plasminogen activator, heparin-like molecules Prothrombotic VonWillebrand Factor, tissue factor, plasminogen activator inhibitor

6. Vascular Smooth Muscle Vasoconstriction Dilatation Collagen, elastin synthesis Cellular proliferation in atherosclerosis

7. Vascular Diseases Congenital anomalies Atherosclerosis Hypertensive vascular disease The vasculitides Raynaud’s disease Aneurysms Vascular tumors

8. Congenital Anomalies Berry aneurysms AV fistulas

9. Atherosclerosis Elastic and medium sized arteries Atheroma is the basic lesion Age, male, genetic LDL, VLDL Monocytes - macrophages - foam cells Endothelial injury

10. Atherosclerosis

14. Risk Factors Major diet and hyperlipidemia, hypertension, cigarette smoking, diabetes Minor obesity, lack of exercise, age, male, family history, stress, BCP, High CHO intake, hyperhomocysteinemia

15. Hypertension Idiopathic, essential Renin - Angiotensin Accelerated atherogenesis Hyaline atherosclerosis

16. Vasculitides Giant cell arteritis Takayasu’s arteritis Polyarteritis nodosa Kawasaki disease Wegener’s granulomatosis Buerger’s disease

17. Giant Cell Arteritis Rare before age 50 Throbbing pain Visual disturbances Temporal artery Corticosteroids Polymyalgia rheumatica

18. Giant Cell Arteritis

20. Takayasu’s Arteritis Fibrous thickening of aortic arch Upper extremity pulselessness Females 15 - 40

21. Polyarteritis Nodosa Systemic involvement Fever, weight loss, hypertension Abdominal pain Melena Muscle aches Motor peripheral neuropathy

22. Polyarteritis Nodosa

23. Kawasaki Syndrome Young children and infants Fever, conjunctival and oral erythema and erosion, edema of the hands and feet, erythema of the palms and soles, desquamation, lymph node enlargement Leading cause of acquired heart disease in children

24. Wegener’s Granulomatosis Acute necrotizing granulomas of the upper and lower reap tract Focal necrotizing vasculitis Renal disease 5th decade of life Immunosuppressive therapy

25. Wegener’s Granulomatosis

26. Buerger’s Disease Thromboangitis obliterans Cigarette smoking “instep” claudication

27. Buerger’s Disease

30. Raynaud’s Disease Small artery, arteriole vasospasm White, blue, red

31. Raynaud’s Disease

33. Aneurysms Abdominal aorta frequently affected Natural history is to rupture Ischemic intima and media? Male caucasians Early detection

35. Dissection Type A Type B Hypertension Double lumen

36. DeBakey Classification

37. Dissection

38. Vascular Tumors Hemangiomas, Glomus tumor, Vascular ectasias ( nevus, spiders, Osler-Weber- Rendu disease) Angiosarcoma, Kaposi’s sarcoma

39. Hemangioma