- Cardiac insufficiency
- Congenital heart defects
- Acquired valvular defects
- Bacterial Endocarditis
- Heart block
- Atrial fibrillation
- Paroxysmal tachycardia
- Coronary heart disease
- What is atherosclerosis?
- Bürger's disease (or thromboangiitis obliterans)
- Raynaud's disease
- Blood vessel tumors
- Varicose veins
What is heart failure?Heart failure (congestive heart failure or, to use the technical term) is the condition in which the heart, hypertension or heart disease, weakened and no longer contract properly, i.e. "pump" in the arterial system 70-80 milliliters of blood needed.
The consequence of this is the dilation of the heart, known as dilated cardiomyopathy.
This condition can occur as a result of heart failure, uncontrolled hypertension, valvular disease, viral and bacterial, atherosclerosis, but may also have a genetic origin, meaning "encoded" on DNA.
Which presents symptoms of heart failure?The most common symptoms are:
to) relatively easily tired;
b) difficulty breathing after an effort initially, and then even at rest;
c) inability to remain lying down in bed without having difficulty breathing. People who suffer from heart failure have thus need more pillows to keep erect the head and upper body;
d) sudden night attacks of choking, which force the patient to sit on the bed or get up and trying desperately to send air to the lungs;
and cyanotic) coloring lips, nails and skin;
f) serous fluid retention of subcutaneous tissue (edema) in the chest, abdomen and other parts of the body; This can cause swelling of the feet,
ankles and legs, usually gets worse towards evening, to improve overnight.
How long after a damaged heart or over-tired begins to be inefficient?It is a subjective phenomenon, which has remarkable differences from patient to patient. The heart shows a remarkable capacity to carry out their work for years in very difficult conditions and begins to be inefficient when only become insurmountable difficulties.
Heart failure is lethal?No. Today heart failure is in many cases controllable by appropriate drugs (Digitalis, diuretics, ACE inhibitors, beta blockers), associated with therapeutic measures, including the limitation of physical activity, proper diet low in salt and the abolition of smoking. In a relatively low percentage of cases the disease solution is represented by cardiac transplantation and, as an aid in anticipation of the same transplant, from the system of the so-called "artificial heart". It is a left ventricular mechanical, powered by an external battery brought to life by the patient, which is implanted under the heart and connected by two tubes.
In addition to cardiac transplantation, there are other useful surgical techniques to combat heart failure?Yes; but it is still semisperimentali questioning techniques. Are cardiomyoplasty, laser Revascularization of the left ventricle and the left ventricular reduction (see sub-chapter heart surgery).
CONGENITAL HEART DEFECTS
What are congenital heart defects?abnormal Communication) between the left part and the right part of the cardiovascular system, whereby the first arterial blood ends up mixing with that, or oxygenated, not the second. These malformations are also called, more briefly, left-to-right shunt and include the interventricular septum, interatrial communication and persistence of the ductus arteriosus (communication normally present in the fetus between the aorta and the pulmonary artery);
b) heart valve injuries or blood, with or without a right-to-left shunt.
Include all congenital valvular defect, coarctation of the aorta and tetralogy of Fallot;
c) abnormality of the origin of large arteries and veins that come from the heart;
d) incorrect location of the heart in the thorax, like cardiac dextroposition
From what originated congenital heart defects?Congenital cardiac malformations arise from an abnormal development of some structures of the embryo, or by a delay or a stoppage in the maturation of these structures. There are many causes, and for the most part not yet been clarified. Only rarely can clearly identify a causative factor; for example, the incidence of congenital defects increase when the mother is affected by rubella in the first three months of pregnancy, or if it's a chronic alcohol abuse. It has also been shown that certain products (for example, thalidomide) can cause the embryo heart defects and other malformations, whereby it is recommendable not to assume, during the first
three months pregnant, any medicines without precise medical clearance. Congenital heart defects are caused also by various modifications which occur in the genome (genetic) and not yet well understood.
Congenital heart defects are hereditary?No, except in a small, but well defined percentage of cases.
You can verify the presence of a cardiac defect at birth?For some forms, Yes, the heart of newborn auscultando with stethoscope, or, as in the case of blue, bluish coloration of the skin (cyanosis). Other cardiac defects manifest themselves in later childhood or adulthood.
What is a "blue baby"?A child suffering from so-called blue baby syndrome, or blue, or tetralogy of Fallot: a disease for which the venous blood passes directly from the right side to the left side of the heart, without being pumped through the lungs and, therefore, without being oxygenated.
What is the incidence of congenital heart defects?Approximately nine per thousand.
Congenital heart defects are severe disorders?Yes, since they often affect cardiac function and blood circulation, so the fabrics are not sufficiently oxygenated.
Congenital heart defects can be treated?Surgical therapy of congenital forms have been made in recent years enormous progress, allowing currently successfully treat some cardiac defects and get to at least one other significant improvement.
(See subchapter also cardiac surgery.)
ACQUIRED VALVULAR DEFECTS
What are the valve defects or acquired valve disease?Are diseases of the heart valves that develop in adolescence or adulthood. Can hitting all four valves, but most frequently those of the left side of the heart, i.e. the mitral valve and the aorta.
How many types are there?Two for each valve. The stenosis, in which the valve is tighter than normal and leave then spend less blood, and shortcomings, in which leaflets do not close perfectly, so the blood contained in a cardiac cavity flows back, back, into the cavity. Is referred to as mitral regurgitation or stenosis, aortic etc.
What are the main causes of acquired valve disease?The most frequent cause is rheumatic fever. It is a disease that followed, after some time, to a streptococcal infection, for example at the level of the tonsils, generally poorly treated. Follow the bacterial endocarditis, which generally occur on already diseased valves.
Are serious diseases valvulopathies?Not always. Depends on the extent of damage to the valve, the timeliness of diagnosis and therapy. Today, thanks to heart surgery, is to completely luck can correct even more serious defects, allowing people with these diseases to perform a perfectly normal life.
Such symptoms usually have valvular heart diseases?In the initial stage usually do not give any trouble. Later may appear easy fatigability, difficulty in breathing and to make efforts, chest pains, fainting. Then all the symptoms of heart failure are well advanced.
How does the doctor to realize a valvular heart disease?Initially the auscultando heart with stethoscope and noting the presence of a breath.
What is a puff, or noise, heart attack?A sound produced, typically, but not exclusively, from the abnormal movement of blood through damaged valves (incontinent or stenotic).
Heart murmurs in any case imply necessarily and cardiac disease?No; a large number of heart sounds are also produced by a perfectly healthy heart and, from a clinical point of view, not have any symptom.
What is a functional heart murmur?A noise that has nothing to do with cardiac disease.
What is a heart murmur organic?A noise that is associated with cardiac disease.
Your doctor can tell if it is a functional or organic heart murmur?Usually Yes, and without any particular difficulty, depending on the character and location of heart murmur than the heartbeat cycle, and other distinguishing characteristics.
In individual cases, the nature of the breath is not clear, so the diagnosis is difficult. Your doctor will then more specific tests as radiography and, especially, the Echocardiogram.
What is bacterial endocarditis?Already damaged heart valves from a rheumatic fever, congenital defects or other diseases are particularly susceptible to bacterial infections, meaning the attack by germs that enter the bloodstream, they are located in them; inflammation of the endocardium which is precisely defined bacterial endocarditis. This is a very serious complication that, if not treated promptly, irreparably damages the heart valves; Add to this the fact that bacteria are carried by the bloodstream to other organs, where they can, resulting in other inflammatory reactions, producing severe damage.
Bacterial Endocarditis can be cured?Currently Yes, and in most cases successfully.
What is the most appropriate therapy?Prolonged administration of high doses of antibiotics.
You can prevent the emergence of a bacterial endocarditis?To a certain extent, Yes, promptly and with a shock therapy any organic infection, to prevent bacteria from crossing the barriers formed by tissues and blood spread, you settle in a heart valve.
What other measures you can take to prevent the occurrence of a bacterial endocarditis?Anyone suffering from a heart valve defect of rheumatic origin must proceed with caution in undergo surgery; even the simple extraction of a tooth, for example, must always be preceded and followed by a treatment with antibiotics.
What is the arrhythmia?An alteration of both heart rate and rhythm, and the propagation of electrical impulse that causes the contraction of the heart.
From what originated?In some cases, by a real illness, in others is also found in a normal heart that, for whatever reason, beats with irregular rhythm. Usually, however, the doctor is able to determine the exact cause of such alteration.
Arrhythmias affect heart function?Depends on the type of arrhythmia; If it's an occasional extrasystoles, i.e. a premature contraction of the heart or any part thereof, the cardiac function is not impaired if not minimal; other types of arrhythmia can seriously interfere with blood circulation.
Arrhythmias can be successfully treated?In most cases, people suffering from these disorders react positively to a certain cardiac drugs therapy.
Why the heart "stops" or "disorderly" beats?This unique feeling, which the patient experiences in cardiac region in the form of palpitations, strokes, sudden slow heartbeat or heart stop, is due to that type of arrhythmia called occasional PVCs. Among the premature contraction and subsequent normal heartbeat occurs often a slight pause that raises the nagging feeling of a heart stop.
What consequences does the extrasystole?In the vast majority of cases, this disorder has serious consequences, but it is often annoying.
From what originates the extrasystole?By a multiplicity of factors, including excessive tiredness, nervousness, irritability, acute infections, medication taken unnecessarily or in excessive doses etc.; more rarely, by an illness.
Smoking can cause the extrasystole?Yes; Indeed, it is one of the most common causes of this disorder.
What is heart palpitations?This popular expression used to indicate an increase in the frequency of the heartbeat, which is experienced by the individual clearly concerned; sometimes palpitations appear to coincide with an arrhythmia.
Palpitations imply the presence of cardiac disease?Usually, no; in the majority of cases occur in people prone to violent tension and anxiety.
What is heart block?Alteration of conduction of the electrical impulses of the heart, that normally occur in the foyer and then transmitted to the ventricular contraction in the succession of the two cavities. The heart block may be total or partial: in the first case, the impulse that causes the contraction of the heart muscle is not transmitted from the atrium to the ventricle, which can lead to the complete shutdown of the heart, the cessation of heartbeat and death, or simply a momentary heart stop, with loss of consciousness and events like a stroke. However, it can also happen that the ventricles to assume the task of training the impulses and work independently of the other. The heart block is defined when a partial instead only on two or three pulse is transmitted from the atrium to the ventricle; in this case, the consequences are far less dramatic than those caused by total heart block.
The heart block is usually associated with cardiac disease?Yes.
As is generally diagnosed a heart block?A careful examination of the heart, complemented by an electrocardiogram.
The heart block is compatible with normal existence?Depends on the severity of the block. The sufferer is constantly threatened by the possibility that painted the ventricles stop beat or an alteration of their business will be lethal.
What you can do when your heart block threatens the survival of the patient?Through surgery can be applied, temporarily or permanently, an electronic device known as a pacemaker, which electrically stimulates the ventricles to beat with force and regularity.
What is atrial fibrillation?An arrhythmia characterized by unusually rapid and disorderly activities of the Atria, resulting in uncoordinated transmission of impulses to the ventricles, which gives rise to a completely irregular heart rhythm, the so-called comprehensive arrhythmia.
From what originated atrial fibrillation?This disorder usually appears in the presence of pre-existing valvular defects for a long time and of rheumatic origin, cardiac affections caused by atherosclerosis and hyperthyroidism (too much thyroid gland function).
What consequences does atrial fibrillation?A heart beating irregularly is less efficient than a heart with a regular rhythm; This lower efficiency results in an incorrect blood circulation.
What complications can arise in case of chronic atrial fibrillation?heart failure); myocardial contractions being too fast and uncoordinated, the efficiency of the heart is reduced;
b) thrombus formation in the Atrium, with consequent danger of embolism when these blood clots break off and are being transported to other organs.
The beat of a heart suffering from atrial fibrillation can be brought back to normal?In many cases, Yes, the so-called cardioversion. This can be done either with the help of medicines, or electrically by a defibrillator (a device that, through a low voltage electric shocks applied directly on the patient's chest, is able to restore normal heart rhythm).
Often, however, this is only temporary success, because after some time my heart is struck again by this particular arrhythmia. To the temporary nature of the benefit is at an advanced stage, the implantable defibrillator, miniature system that, under a muscle and powered by a battery, is capable of recognizing the arrhythmia and intervene with a small electric shock.
It also uses minimally invasive surgical techniques, such as radiofrequency, abla, heart tissue responsible for the arrhythmia: a catheter about 2.5 mm in diameter is brought inside the heart through a vessel (often the femoral vein) and then connected to a radio wave generator. This method is currently used most of those employing lasers, microwave and cryogenic applications because it is more secure.
What is the paroxysmal tachycardia?A form of irregular heartbeat that suddenly takes on a pace much faster than usual. These attacks usually occur suddenly and without warning signs, more or less prolonged intervals.
How long do such attacks?From a few minutes to a few days.
These attacks affect only the heart?No; often, people with healthy hearts.
What caused the paroxysmal tachycardia?In most cases the cause is unknown, affected individuals have no sign of organic disease. In other cases there may be a
mitral valve disease, a congenital atrial septal defect, or other heart conditions. The mechanism by which this occurs is abnormal stimulation of a central generating electrical impulses, that when the heart rate is normal, it does not manifest itself.
How to cure the paroxysmal tachycardia?Usually you can terminate an attack using appropriate medicines, such as Digitalis or beta-blockers. In some cases, when these measures are not sufficient, we resort to the use of the defibrillator. As for atrial fibrillation, often attacks recur and sometimes when they are too frequent, you need to take medications to prevent its onset.
CORONARY HEART DISEASE
What are the coronary arteries?The coronary arteries are the blood vessels intended for spraying of the heart.
Arise separately from the initial segment of the aorta (right coronary artery and left coronary artery) and the surface of the heart penetrate inside, widely branching.
What is coronary artery disease?All those diseases that affect coronary circulation of mu heart drain. Given that the heart is in continuous activity and that this constant work involves a huge energy consumption, it is understandable as the myocardium requires a good circulation and how this can be ensured only by the proper functioning of the coronary arteries.
What is the most common cause of coronary artery disease?Atherosclerosis.
What is coronary heart disease?This term defines the particular condition whereby the coronary artery, following a process of narrowing (stenosis), are no longer able to ensure sufficient blood supply, which therefore can not work with the necessary energy. In such a case the heart gives out, so to speak, an alarm signal, which can manifest itself as a sudden, sharp pain or tightness in the chest, usually under the breastbone. The pain may radiate to other parts of the body, for example in the back, arms, neck, and jaw in the region over-umbilical (epigastrium), and in many cases can occur as a result of overwork.
This symptomatology, which disappears if the patient observes a rest and avoid any physical exertion, is usually called angina pectoris (see below).
What is a coronary occlusion and myocardial infarction (or heart attack)?Occlusion of the coronary arteries is called the complete interruption of blood flow in a coronary branch; as a result, a more or less extended portion of the myocardium is no longer receiving blood and ends up become necrotic, IE to lose any vital function: in similar cases, we speak of myocardial infarction. If it concerns a large occlusion of coronary artery branch, it remains a rather large portion damaged cardiac muscle; If the interruption occurs in a small secondary branch, the damage of course remains restricted to a small portion of the myocardium. This sequence of events is defined, in common parlance, "heart attack".
What is coronary occlusion?Usually by a blood clot (thrombus), which normally forms in an artery wall point already impaired by atherosclerosis, in which case it comes to coronary thrombosis.
What factors determine the whereabouts of an individual suffering from a heart attack?in) the age and general health of the subject;
b) the presence or absence of a pre-existing cardiac injury;
c) extending the portion of damaged myocardium;
d) extending the portion of the myocardium was working;
and) the appearance of a cardiac arrhythmia;
f) the formation of blood clots in the heart, which could become detached from the wall and be transported to other parts of the body;
g) possible laceration of heart wall weakened;
h) rupture of the heart valves;
I) the possibility that the same disease that caused the heart attack can strike other coronary branches.
The extent to which the coronary insufficiency or "angina pectoris" are detrimental to the patient's general condition?As was mentioned earlier, the term "angina pectoris" indicates that complex symptoms that usually appears in presence of coronary insufficiency. These disorders can occur with varying severity from case to case, severity that depends on the extent of coronary artery disease, i.e. how many branches are affected and to what extent stenosis.
In milder cases chest pain appear only after heavy efforts in those more serious even at rest. In all cases, however, the patient must be kept under close medical supervision and comply scrupulously and prescrittagli therapy on a regular basis.
People with angina pectoris are not necessarily meant to be affected by coronary occlusion?No, although they are still much more exposed to the risk of a heart attack.
You can prevent attacks of angina pectoris?To a certain extent, Yes. Conducting a regulated life, as much as possible without physical or psychological stress, avoiding cigarette smoke and taking appropriate medicines.
The coronary artery disease can be cured surgically?Yes. When the medications are not sufficient to prevent attacks of angina pectoris, it becomes necessary to intervene surgically practicing so-called by-pass grafting surgery; Thanks to the continuous refinement of methodologies, this allows a large part of coronaropatici can continue to lead a life
almost normal. In appropriate cases, currently also used in a technique less aggressive, angioplasty, which allows occluded coronary obstructions (see sub-chapter heart surgery).
What tests can confirm the diagnosis of myocardial infarction?Echocardiogram and determination, blood, some cardiac enzymes.
How to treat heart attacks?First of all individuals affected by myocardial infarction should be admitted as soon as possible in special wards, called "coronary intensive care unit" so that they can be kept under close surveillance and so can prevent the onset of serious complications. In the early stage of the disease the subjects must observe absolute bed rest and avoid stress as much as possible. Drugs that are administered in the early stages of heart failure are different: first fibrinolytic drugs, analgesics to soothe pain, drugs that dilate the coronary vasodilators such as ni Ty, or which reduce the heart's work, such as beta blockers, and anticoagulants (see below). In the case of serious arrhythmias arise you will also of antiarrhythmics, or even it may be useful to use the defibrillator.
There are remedies that can prevent the development of a heart attack once the attack has already begun?Yes, and it is the result of recent advances in medicine. Currently there is the possibility to inject into a vein, or even directly into the coronary artery, a substance that can, in most cases, to dissolve the clot formed.
This substance, urokinase, can be given only if the attack is started by a few hours. The time factor, it should be stressed, it is essential to overcome the heart attack. Fibrinolytic therapy, which uses thrombolytic drugs such as urokinase (drugs capable of dissolving blood clots that block the lisando coronary fibrin contained therein), it should be established within the first six hours of the onset of symptoms. Once the Thrombolysis, goes the anticoagulant and antiplatelet therapy with medications such as aspirin (ASA) and heparin to reduce the risk of coronary reocclusion. Finally, there is the possibility to refer the individual to infarcted immediate by-pass or angioplasty.
Why bed rest and limitation of physical activity are so important?Because a limited means less activity on the heart to circulate the blood flow; the difference between the amount of energy consumed by heart at rest and during normal activity is so strong as to appear almost unbelievable.
In case of heart attack, how long you have to stay in bed?According to the most modern theories, immobilization in bed is only needed for one week; then it will be necessary to gradually resume physical activity, for example, starting with the sit in your Chair for a few hours, and so on. Rehabilitation of stroke patients is now possible in special centers and provides, in addition to the usual therapies, physiotherapy and psychiatric care.
After a heart attack how long you must not work?You can usually return to work two months after the attack, gradually intensifying the activity; If you exercise very stressful professions, you should modify its functions. Most people can and even should resume work after a heart attack, though most assuredly avoiding efforts and tensions, both physical and psychological.
What are anticoagulants?Chemical compounds that inhibit the normal blood-clotting ability (the most commonly used are dicumarina and heparin, or dicoumarol).
For what reasons the coronary thrombosis is treated with anticoagulants?in) to prevent the clot formed in a coronary artery will spread in other blood vessels and, consequently, that the coronary circulation is further affected;
b) to prevent the formation of a thrombus in the endocardium and veins of the legs.
These clots may break loose and then would be transported by the blood stream to other vessels, with consequent danger of clogging, or embolism. (It has recently been identified as a key factor in the thromboplastin genesis of thrombus in patients suffering from angina; targeted drugs are being studied.)
You can predict heart attacks?Not always. In many cases are affected suddenly and apparently healthy people whose electrocardiogram appeared normal immediately before the attack. However, there are also cases in which weeks or months before a acute attack warning signs appear, such as chest pain.
Electrocardiographic examinations carried out regularly can highlight the possible risk of heart attack?Only in rare cases.
At what age you are more prone to heart attack?Between 40 and 60 years.
After a heart attack can live for many years?Yes; However, it is essential to observe an appropriate lifestyle, remain under medical supervision and take prescribed medications. In these conditions, if not cardiac damage was particularly severe, the predictions of life are good.
Men are more prone than women to heart attack?Yes; the tendency to coronary artery disease in men is three times higher than women. After fifty years, however, the incidence of coronary thrombosis in women increases significantly.
What is the role of emotional stress in the onset of a heart attack?Emotional stress may contribute to the onset of a heart attack, but usually I'm neither the only nor the main cause.
Heart failure can be avoided?Prevention is important, connected with the global risk assessment where an individual is exposed, being the damage to coronary multifactorial nature.
Major risk factors on which action must be taken which are smoking, hypertension and hypercholesterolemia (see below).
Myocardial infarction can be related with infectious diseases?As in 50% of subjects infarcted doesn't highlight the risk factors mentioned above, it was suggested that in such cases the heart attack may have a Genesis. Helicobacter pylori and Chlamydia were identified in atherosclerotic plaques that clog the coronary arteries.
There is an inherited predisposition to coronary heart disease?In some cases there seems to be a hereditary tendency, wrong though seen as exclusive and sole cause of disease.
Physical efforts affect the occurrence of coronary heart disease?In General, physical efforts do not constitute a determining factor in the onset of heart attacks. In some cases, though, these occur during or shortly after violent physical efforts: in similar cases, there was probably a pre-existing coronary artery disease, undetected, and consequently a certain predisposition to heart attack.
What factors stimulate susceptibility to coronary heart disease?Diabetes, high blood pressure, high blood cholesterol (hypercholesterolemia), obesity and smoking habits much.
What is cholesterol?Is a component of the lipid metabolism of the organism is present in all animal tissues, whose total level should be within the maximum limit of 240 mg/dl.
The use of new drugs, particularly of Statins against hypercholesterolemia proved useful in preventing second heart attack, stroke and death from coronary heart disease.
Who has the power to influence on coronary heart disease?The appearance of coronary heart disease seems related also to different eating habits, for example, a diet rich in saturated fats or foods high in cholesterol.
That influence smoking on the coronary heart disease?Today there is general agreement that, all other conditions being equal, the probability of being affected by these illnesses are much more the more you smoke. However, it is found that in the presence of coronary artery disease should give up smoking completely.
WHAT IS ATHEROSCLEROSIS?Complete dossier
• Cholesterol, diet and nutrition
• Cardiovascular Drugs
What is atherosclerosis?A disease that causes lesions characteristics of arteries. The normal part of an artery is resistant and flexible, so that you can release and contract in accordance with changes in blood pressure resulting from every heart systole. When an artery is affected by atherosclerosis, loses elasticity, becoming rigid and fragile: this occurs due to abnormal deposits (atheromas or plaque) deposits on the walls leading to the gradual narrowing of the lumen and can end up completely occlude the vessel so as to prevent the flow of blood.
What is due?Do not know the exact cause, but considerable progress has been made in recent years in the study of this disease. It is related to risk factors such as hypertension, hypercholesterolemia and hypertriglyceridemia, obesity, smoking, diabetes. Between blood lipoproteins is attributed a role to atherogenic LDL (low density lipoproteins) and VLDL (very low density lipoproeine), while a security role attaches to HDL (high-density lipoprotein).
In the genesis of atherosclerosis, as well as risk factors, today is the infectious hypothesis, according to which the initial lesion of blood vessels would be linked to the action of some pathogens.
Why atherosclerosis affects certain individuals as early than others?It is assumed that the early appearance of this disease is due to a congenital predisposition, by certain people, to develop the typical changes in the arterial wall. Its onset seems to be determined by eating habits and certain risk factors (smoking, sedentary lifestyle, stress etc.).
Which individuals are more prone to early manifestation of atherosclerosis?diabetics);
c) hypertensive (i.e. people with elevated blood pressure);
d) people that have a particularly rich in blood fats;
and) individuals exposed to risk factors previously appointed.
Atherosclerosis tends to recur early within the same family, or even hereditary?Is not hereditary, but in some families there is a tendency to early disease manifestation which, however, only occurs in other very advanced age and fit very mild, or
all asymptomatic. In all likelihood, the dietary and environmental factors are therefore more important than hereditary ones.
What are its symptoms?Depends only on the location of the disease and its entities.
Basically the symptoms are caused by arterial insufficiency: If, for example, are affected coronary arteries of the heart, the subject may present crisis of angina pectoris due to stress; in case they are affected lower limb arteries, the patient may suffer from intermittent claudication (intense cramps and muscle pain in the legs when walking). In case it is instead hit the cerebral vascular district may cause reversible cerebral ischemic attacks (RIA), or you can reach the stroke (cerebral infarction).
How is usually diagnosed atherosclerosis?You can follow different routes. For example, a fundus examination using ophthalmoscope can often reveal the hardening of the arteries of the retina, while arterial sclerosis of the upper and lower limbs can often be detected with simple palpation of the arteries themselves. Radiographic examination of various organs in many cases highlights the characteristic look of hardened blood vessels; Special x-ray examinations, called arteriografie, can show the narrowing of the lumen of the vessels, which is one of the symptoms of atherosclerosis.
Are very useful techniques such as ultrasound Doppler investigation, allowing the blood flow analysis.
There are safe ways to prevent atherosclerosis?No. However, you can take adequate precautionary measures: for example, whether a person is obese, trying to reduce weight; If you're used to consume foods high in cholesterol, eliminating them from your diet for fibre-rich foods; If you are hypertensive, while controlling your blood pressure.
These measures can delay the atherosclerotic process.
Hardening of the arteries always results in symptoms?No. A very slight atherosclerotic process may not result in any symptoms; In addition, smaller vessels are not usually involved in the disease process, and in that case can do the job that was done by larger vessels sclerotized. Thanks to the establishment of this "collateral", a lower limb struck by a marked main artery atherosclerotic process can function normally.
There is a very effective treatment of atherosclerosis?Not always; in many cases you can achieve very positive results, for example, with acts to release vasal spasm that accompanies the disease process and thus promote the blood circulation. In the treatment of atherosclerosis are also employed several techniques such as surgical endarterectomy, an operation whereby the inside sclerotized artery is removed, so that the widening of the lumen. Of course, there are also replacement interventions where a dacron or Gore-Tex or saphenous vein of the patient itself is inserted to replace a section of a sclerotized.
Bed rest benefits those suffering from atherosclerosis?Yes, when a complication such as an infection or an ulcer. Also, if the blood supply to an organ is decreased, the organ itself needs a longer break to perform his work properly.
A subject clearly should limit their atherosclerotic activities?Yes; such a patient must learn to keep those boundaries that its circulatory failure causes.
The habitual intake of alcohol can lead to premature hardening of the arteries?According to recent studies, moderate consumption of alcohol, especially wine, seems to have a positive function in nutrition and health. In addition to promoting gastric secretion, and thus the digestion, the wine contains vitamins, minerals and antioxidants: these substances that help prevent the development of atherosclerosis. Red wine, in particular, can increase the amount of HDL-bound cholesterol, which is considered beneficial, and reduce the formation of thrombi. This does not mean, however, that "habitual intake" should become "alcohol abuse"; which maximum daily doses, so as not to exceed are indicated 20 ml of alcohol (equivalent to two small glasses of wine) for men and 14 ml (1 cup) for women not pregnant.
Smoking may be a factor in premature atherosclerosis?According to recent surveys very reliable, the smoke would be an important causal factor.
Obesity can promote the early appearance of atherosclerosis?Yes, especially if you have children.
Atherosclerosis may resolve spontaneously?No, but in many cases the pathological situation is relatively static, so as to allow the patient a completely normal life.
Once started, the atherosclerotic process can improve or heal with a special diet and proper rest?No, because the disease is evolutionary; Therefore, when you have already produced a sclerotherapy, the process is no longer reversible.
There is a correlation between high levels of blood fats and atherosclerosis?This report has not been definitively proven. a high level of cholesterol, however, is often associated with atherosclerosis.
What are the major dangers of atherosclerosis?An early atherosclerosis causes premature ageing, with decreased organic vitality and efficiency. If the disease process affects the arteries of the heart, can experience a coronary thrombosis which can follow a heart attack; If compromises, cerebral vessels may occur, senility cerebral thrombosis or hemorrhage; If they are interested in the arts, the consequences can be muscle cramps, circulatory or gangrene.
How can the doctor determine the degree of evolution of the disease?With a periodic inspection of the patient, which allows him to detect the appearance of new symptoms.
Surgery is helpful in the treatment of atherosclerosis?In a number of cases, Yes.
What are the specific surgeries of atherosclerosis?Sympathectomy) (or sympathectomy);
c) strokes arterial grafts (arterioplastica);
What is the sympathectomy, and when you practice?Is performed in order to sever the sympathetic nerves that cause contraction and constriction of blood vessels; These nerves run in front of the spine and are achieved by the surgeon with an incision on the abdomen practiced. Such intervention is indicated in those cases of atherosclerosis of lower extremities in which you believe that the Elimination of arterial spasms can improve blood circulation. Sympathectomy is also indicated for certain cases of Bürger's disease (see below).
What is tromboendoarteriectomia?An operation that removes the inner part, sclerotized, artery, reconstituting a normal arterial wall.
In which cases do I tromboendoarteriectomia?Especially for localized narrowing of the arteries of the lower extremity and neck, and only when the downstream arteries narrow tract are not affected by the disease.
How do tromboendoarteriectomia?You can use two techniques: the first, now little used, the artery is opened longitudinally, the restricted section is normalized, after that you run a suture. With the second, you run two small incisions, one upstream and one downstream of the small tract, penetrate from the first and second leak from a small ring that the sick inner wall and allows the removal; Finally the two incisions are closed.
What are arterial grafts, and in which cases we resort to their use?In patients in whom a large arterial vessel (for example, the aorta or carotid artery) appears sclerotized not allow blood to pass except in very small quantities, you can replace the vessel with a compromise section, normally of dacron or other synthetic material and very similar to the vessel that needs replacing. Such measures have already been implemented, with very satisfactory results, out of thousands of people.
What is the recommended enzymopathies use a graft?The use of synthetic grafts in vascular surgery is extremely effective in a variety of pathological process, including:
in) in certain cases of stroke. It has been found that quite often this is due to carotid artery atherosclerosis and, in similar cases, is often a significant improvement can be achieved by replacing the vascular compromise tract with a dacron graft or teflon;
b) in many cases of atherosclerosis of abdominal aorta, enhanced to the point that might seriously affect the blood circulation of the legs. Even in such cases, it is advisable to replace the abdominal aorta with a synthetic graft, very similar to the aorta; or remove the inner wall sclerotized (tromboendoarteriectomia), inserting a synthetic graft to widen the vessel lumen;
c) in the presence of multiple sclerosis and stenosis (narrowing) of the renal arteries, which have given rise to a State of hypertension. In this case, a tromboendoarteriectomia and the subsequent insertion of a dacron graft or teflon, in order to widen the artery lumen, can get very satisfying results.
d) where blood circulation in the lower limbs is severely compromised by a process of atherosclerotic femoral or pelvic. In some cases you can replace the sclerotized vase with a synthetic graft. This, however, most surgeons prefer to transplant a vein where it is necessary to work around a stenosis, which arose in the arteries at the knee, with the creation of a bypass;
and) in the presence of an aneurysm of the aorta, located in the thoracic or abdominal stretch of that artery.
The aneurysm is a limited expansion of an artery, which occurs as a result of a weakening of the arterial wall, caused by trauma or pathologic alteration; If you do not act promptly, the vessel wall, in the area affected, it can rupture, causing bleeding to death of the patient. To avoid this danger, it may remove the affected section of the aorta, replacing it with a synthetic graft recently, finally, proved how certain abdominal arteries that supply large portions of the bowel may be affected by atherosclerosis and how it is possible to replace with a dacron graft or teflon.
BÜRGER'S DISEASE (OR THROMBOANGIITIS OBLITERANS)
What is Bürger's disease?A chronic inflammatory disease, also known as thromboangiitis obliterans, which affects certain arteries and veins (predominantly of the extremities), usually causing obstruction (hence the term obliterans) in consequence of the thrombus formation.
Occurs more often in men between the ages of twenty and fifty years.
What caused?You do not know the exact cause, but it is interesting to note that the majority of patients is represented by heavy smoking.
What are your symptoms?Symptoms result from inflammation of the blood that end up become clogged.
The patient may experience a sensation of cold or pain, similar to needle sticks, in one of the extremities, intended as a result of becoming violent and localized to the tissues perfused by blood vessels. Finally, you may experience the consequences of insufficient blood supply, i.e. ulcerations or gangrene, areas on the skin of the affected extremities, gangrene, which may end up compromising a toe or even the entire leg.
This disease is more frequent in some races than others?At one time it was believed that Bürger's disease predominasse among the Jews, but recent statistics have shown that has spread worldwide and not limited to one ethnic group.
What is the medical treatment of Bürger's disease?a total prohibition on smoking), either directly or indirectly (i.e. breathing other people's smoke). Many patients show a considerable and immediate improvement already few weeks after quitting this habit;
b) administration of corticosteroids, anti-inflammatory drugs (NSAIDs), anticoagulants and vasodilators. combination therapy often gives good results.
Surgical therapy gets positive results against Bürger's disease?Yes. In selected cases the lumbar sympathectomy (i.e. practiced severing the nerves of the lumbar region governing vessel contraction) is very useful.
Lumbar sympathectomy surgery dangerous?No, the operative risk is very low.
How do lumbar sympathectomy?We practice a transverse incision on the side of the abdomen at the navel; then isolate and cut off the nerves that control the contraction of the arteries of the lower limb.
What is the prognosis for people with Bürger's disease?The disease tends to become chronic and lasts for many years. If it has not reached
a stadium too advanced, and if the patient has stopped smoking and complies with other requirements, is in many cases possible to avoid more serious complication, i.e. limb gangrene.
What is Raynaud's disease?A disease characterized by violent spasms of the arteries of the fingers of both hands both feet. These crises are often caused or by emotional stress or exposure to cold and moisture. Occasionally can be also involved the ears, nose, Chin or cheeks.
What is its cause?Is unknown, but the disease tends to affect those who are thin, lean, exceptionally emotional.
Women are more prone to this disease?Yes, especially when young.
What are its symptoms?In the case of emotion or exposure to very low temperatures, one or more fingers become first, then bluish white and go numb then resulting in tingling and pain as from needle sticks. All this takes a few minutes and then disappear, while the circulation returns to normal, leaving a residual short-term redness.
How to treat Raynaud's disease?The morbid condition can remain stationary in mild form for many years.
In a small percentage of cases, however, progressively worsens and may require surgery to cut the nerves that control the contraction of the arteries of the fingers.
What is this intervention?Consists of a sympathectomy, which you run from the sick (or both if the disease is bilateral), incising the skin at the base of the neck just above the collarbone. Then the surgeon severs nerves island and regulating the contraction of the arteries of the upper extremity.
The results that follow are positive?Yes, this surgery leads to healing and usually does not cause unpleasant side effects.
Raynaud's disease may cause ulceration or gangrene of fingers or toes?Yes, in rare cases, and restricted to the upper extremity.
Which therapeutic measures requires that disease?to avoid moisture and cold) excessive;
b) gloves and warm clothes;
c) minimisation of emotional stress;
d) Elimination of smoking in any form;
and use of medicinal products) which promote vasodilation (vasodilators);
f) in certain cases, the use of sympathectomy.
Similar therapeutic measures are really effective against Raynaud's disease?Yes; usually the adoption of one or more of them can be used to alleviate the symptoms.
What is a blood vessel thrombosis?Blood clotting within the vessel.
What are its causes?There are many, most of which are still not known with precision. Some of the most common causes are nevertheless linked with diseases or injuries of the vessel concerned; also process disturbance of blood coagulation can favour the onset. Can also be caused by stagnation of blood after an operation, or it may occur in people who are poor and do not exercise.
What consequences can lead to the presence of a clot in a blood vessel?to Stop blood flow) in the same pot, resulting in gangrene, organ degeneration or sprayed from the pot;
b) a piece of thrombus (blood clot) can break off and reach another part of the body causing serious harm or death.
If a clot breaks off and reaches more headquarters, as is this phenomenon called?Embolism.
A thrombosis can resolve spontaneously?Yes; many affected vessels can return to normal. The acute phase is usually topped with rest and the use of anticoagulants; a thrombus of average size can "organize" and the vessel lumen is reconstituted with a new channel within the thrombus.
What happens to a body perfused from a jar affected by thrombosis?the organ) can degenerate and become Gangrenosum or regenerated;
b) its function can be badly damaged, but any healing can take place with the Organization of the clot and restore blood circulation in the body;
c) minor blood vessels near the gauge hit can dilate properly and flush the organ, keeping it alive and functioning.
What is an embolism?A fragment detached from a clot that has formed in a vein or an artery or the heart wall. The thrombus is then carried by the bloodstream from one region to another of the body until it stops in an artery is occluded.
What caused?It is not known precisely, but it is believed that the activity or effort on the part of a patient suffering from thrombosis can cause a piece of the clot.
What are the symptoms of pulmonary embolism?If the artery is occluded, large-caliber usually sudden and dramatic onset of shock; If the thrombus has reached the brain, can check you apoplexy (stroke); If, on the other hand occluding a vessel in the lungs, may cause shock, pulmonary edema, hemoptysis and dyspnea (difficulty breathing).
Decompression may cause sudden death?Yes; is one of the most common.
A person suffering from decompression can recover from that?Yes; in a large percentage of cases, unless the clot is large, reaching the brain or lungs and has widely caught on the supply of blood to these organs. In many cases involving the brain and lungs, the patient manages to survive.
You can successfully remove a thrombus and thereby re-establish normal circulation?Yes, in some cases where the clot stopped in a vase, or a pulmonary vessel available to the surgeon, or in the brain. However, surgery may be helpful only if it is done promptly, so as to restore blood circulation in the affected organ, before this has been compromised beyond repair.
There is a medical treatment of embolism?Yes, it is necessary to administer ASAP intravenously substances (enzymes) are able to dissolve the clot and release so the occluded vessel; This treatment is also effective in cases of thrombosis.
What is an aneurysm?A limited expansion of an artery, an extroversion which occurs as a result of a weakening of the arterial wall caused by trauma or pathologic alteration.
What factors can be the cause?A congenital weakness) of the arterial wall muscular tunic;
b) trauma suffered by the artery;
c) vascular diseases such as atherosclerosis, syphilis or other infections.
Where form aneurysms more often?May occur in any part of the body, but tend to hit mainly the large arteries, such as the aorta, arteries of the lower limbs or brain.
How to treat?The only effective treatment is surgical. The interventions are carried out in order to remove the section of the artery aneurysm and then replacing the excised artery with saphenous vein graft, or dacron or Gore-Tex.
Surgical therapy of aneurysm is successful?Yes; recent progress in vascular surgery today to get positive results in most cases. All arteries aneurysms can now be solved with excision of the hit and replacing it with a synthetic graft.
What dangers it involves an aneurysm?The vessel wall, into the affected area, is thinned, lassa and can break easily: this occurs in most cases if not treated surgically, often causing the sudden death by bleeding.
BLOOD VESSEL TUMORS
What is the most common tumor of blood vessels?The Hemangioma. This formation can occur simply as a red dot on the skin, or appear as a red spot and extended detected.
Hemangiomas may develop into cancer?No, but if they are unsightly or even disfiguring agrees excise them. The electric needle, or dry ice, is sufficient to remove children, while larger ones may require a large incision and skin transplants.
Hemangiomas grow even in different organs from skin?Yes, they may also form in subcutaneous tissue or organs such as the liver, the intestinal wall or elsewhere.
What symptoms cause blood vessel tumors?These growths are usually asymptomatic. When it manifests a tendency to hemorrhage you have to resort to surgery.
There are malignant tumors of blood vessels?The great majority are benign, but occasionally a malignant tumor can develop into an internal organ affected by angioma.
How to treat?The vast majority, if accessible, should be surgically excised.
Some, for example those that affect the liver, can be left in place only as long as they don't show the tendency to rise quickly or bleeding.
There are other treatments besides surgery for tumors of the blood vessels?Yes; Some tumors may be removed with radiation therapy, other with dry ice applications.
What is conjunctivitis?The thrombophlebitis, phlebitis, or inflammation of vein walls, associated with clots and stopping blood flow in the vessel struck.
What factors may favor the occurrence of thrombophlebitis?stagnation of blood) in the vein, caused by prolonged immobility, long stay standing in the same position, pressure (for example exerted by narrow garters) that disrupts the smooth flow of blood, trauma;
b) formation of a clot in a vein, due to injury, infection or inflammation of his wall;
c) varicose veins, in which the blood stagnates due to insufficient functioning of the valves of the veins themselves;
d) increased tendency to blood clotting, resulting from some of the same diseases.
There is a difference between the phlebitis due to inflammation and phlebitis that occurs sometimes after surgery?Yes. The phlebitis that sometimes follows surgery is best indicated by the term of Phlebothrombosis: in this case it is due to the immobilization sets, resulting in a stagnation of blood flow and clotting of blood within the vein (thrombosis). The inflammatory factor is therefore much less significant.
In order to prevent the occurrence of phlebitis after surgery of considerable gravity, it is important that the patient recovers to move in a short time?Yes; This is precisely the reason why the patient after the surgical operation is done to lift as soon as possible (early ambulation) and induced to perform movements while still in bed. The mobilization activates circulation and prevents thrombosis.
Thrombophlebitis is a common disease?Yes, it is very widespread, particularly in modern society where individuals tend to engage in little Jet and to maintain the same position for a long time.
In past years, when there was more bikes, and phlebitis, varicose veins were much more rarely.
The phlebitis is a common complication of pregnancy?Yes; is the result of the pressure that the gravid uterus exerts on the large veins of the pelvis and impinging on the free flow of blood in these veins to the heart.
When the blood stagnates, you have greater tendency to coagulation.
What subjects are more prone to getting sick of conjunctivitis?Those who have cardiac or are affected by diseases which croni including constipation. It is also easier than the disease hit areas adjacent to outbreaks or traumatized areas.
The phlebitis tends to recur in the same family or is it inherited?It is not hereditary, but disease susceptibility: subjects with venous fragility and varicose veins show greater tendency to contract the disease (varicose veins tend to recur in the same family).
There are diagnostic tests useful for search or deep venous thrombosis, thrombophlebitis?Yes, phlebography and Doppler. The phlebography is a test that uses the invasive injection into a vein before the contrast radiography. The Doppler is a non-invasive test, widely used, estimating the speed of blood by ultrasound.
What happens when the patient is suffering from thrombophlebitis?The inflammation that occurs in the affected vein wall prevents blood to remain in the liquid state; It clots, blocking the same vein.
What steps you can take to prevent phlebitis?do not wear suspenders) (or knee, or suspenders) too tight;
b) those who, for reasons of employment or otherwise, are forced to remain standing in the same position for several consecutive hours must do regularly, for example, to walk;
c) If a person is a heavy smoker, you should stop that habit, because smokers are more easily to the development of this disease;
d) constipation sufferers should take a diet rich in fibre (fruit and veg, whole foods, Bran).
What are the symptoms of thrombophlebitis?Can not be) any symptoms, or may be marked swelling, redness, warmth and weakness in the legs with a sense of weight;
b) inflamed vein may seem to touch a cord thickened;
c) there may be a slight fever.
What is the greatest danger of not meeting following the prescription in the case of conjunctivitis?The possibility that a piece of the clot coming loose, becomes an embolus, and carried by the blood stream, other parts of the body such as the lungs or brain.
How you care for thrombophlebitis?in) With bed rest;
b) through administration of anticoagulants (blood thinners, platelet aggregation inhibitors) to prevent the spread of thrombus, and analgesics to relieve pain;
c) by administering antibiotics to prevent an infection;
d) with bandages to support and relieve soreness veins in the legs;
e) in cases where the clot monsters tend to break away despite therapy adopted, may need surgery, which is to tie the vein higher up, so as to prevent the occurrence of emboli;
f) in some cases the affected vein is exposed, open, instead the clot removed and the wound sutured.
The thrombophlebitis tend to heal spontaneously?Yes, but it is essential a constant monitoring by the physician.
Which generally takes the course thrombophlebitis?The illness usually lasts from three to six weeks to resolve completely.
What are the permanent consequences may give the source phlebitis?If the disease process has damaged many veins, the return movement of the lower limb may be slowed down, in which case it can be limb edema.
Hospitalization is required in case of phlebitis?If the patient is suffering from acute thrombophlebitis with a high temperature, it should be treated in the hospital, where the administration of antibiotics and blood thinners can be better controlled.
Once passed, the disease tends to recur?Yes; the person who has suffered a bout of phlebitis should take care of your health, because it is more exposed than other individuals to relapses.
How can you prevent further attacks of the disease?in the General conditions) improving health and treating any infection exists;
b) following your doctor's advice about running a specific exercise for the legs;
c) avoiding wear garters that will force the legs;
d) in certain cases, following a treatment with anticoagulants for an indefinite period of time;
d) absolutely avoiding smoking.
Wear support stockings or elastic bands can be of benefit to those who are predisposed to thrombophlebitis?Yes, because they promote blood flow from the legs to the heart.
Compression stockings should be worn by every patient suffering from phlebitis?No, only by those who feel better when wearing. Who has the superficial veins and the deep ones suffering from phlebitis may not derive any benefit from the use of support stockings, indeed have an impairment.
What surgical measures can be taken in order to avoid repeated bouts of phlebitis?Ligation of veins more exposed to risk, or, in the case of saphenous veins, their removal, even partially, for extraction (stripping).
What are varicose veins or varicose veins?Dilated veins and inefficient, in which blood tends to stagnate.
Which veins are more easily see of varicose veins?The veins of the legs and thighs. Varicose veins can also form in other districts, particularly in the anal region (haemorrhoids) and scrotum (varicocele).
See in this connection chap. VIII, digestive system.
Because dilate the veins?Essentially because the individual has a constitutionally connective tissue (veins are primarily) weak and inelastic.
In other words, the "fabric" that constitutes the veins is inherently weak.
The appearance of varicose veins is therefore linked to a hereditary factor?Yes. Typically, you inherit the same type of vessels that have parents.
Just the hereditary factor to determine varicose veins?The hereditary factor is the basis; on it they practice some factors favoring, as some professions that force you to stay for a long time and without walking.
The expansion process is fatal or can stop?The expansion is slow but progressive fatally, in the absence of treatment. The veins are provided with valves which allow blood to ascend from the periphery to the heart, in opposition to gravity: they are open to the passage of blood, to quit when circulation slows down; the valves prevent the blood from falling back down. When the vein, congenital weakness, sfianca, valves, flaps that are joined to the vein wall, turn away from each other and loses its function. Therefore the blood, no longer having the valve support, stagnates and in turn results in a further expansion of the vein.
All varicose veins have this source?No, some are secondary varicose veins depend on IE from an obstacle that exists in the deep venous system and affects the superficial veins. This is what occurs in pregnancy, in which the uterus weighs about abdominal veins. In this case the varicose veins do not depend on constitutional weakness of the veins, but from the fact that the blood, because of the obstacle, it cannot flow back in the deep veins, which forced to stagnate in the superficial veins, little by little the sfianca.
Which individuals are more easily affected by varicose veins?Those who are forced to remain standing in the same position for a long time.
The heat (especially those produced by the heating system installed under the floors) promotes varicose veins, as well as when the Sun acts directly. Who is predisposed to varicose veins must therefore avoid sunbathing on the legs.
What is the incidence of varicose veins?A man out of fifteen, one in three women will suffer from varicose veins.
What symptoms cause varicose veins?First, a change in the appearance of the legs, which are visible and tortuous bluish cords. Very visible are especially small varicose veins, called Telangiectasia, which determine the appearance of stains and serpiginose.
Small varicose veins non-subjectively determine disorders. When are extensive and numerous, can produce a feeling of heaviness and fatigue in the legs and, in the evening, the appearance of swollen ankles.
What are the best measures against varicose veins?to) avoid standing in the same position for a long time;
b) do not use suspenders that compel the party;
c) do exertions with regularity and walk;
d) use elastic stockings when you are forced to remain standing in the same position;
and do swimming);
f) avoid direct exposure of the legs in the Sun.
How to treat varicose veins?in) With surgery;
b) with Sclerosing injections.
What is the surgery?The most important surgery is ligation or saphenous vein stripping.
This, the largest vein of the lower limb, ankle, goes on the inside of the leg and thigh and flows into the deep groin level. The operation consists in the groin vein ligation, stick a wire in vein, starting from the ankle up to the groin area, then grasp the vein and remove it. This surgery is called stripping. Currently there is a tendency to perform partial saphenous stripping, removing the portion that lies below the knee or thigh. They also used conservative surgical techniques, aiming not to remove the vein. With the
Chiva (hemodynamic care in ambulatory venous insufficiency) are practiced under saphenous breaks the connection points with deep veins, so that the blood is "sucked" instead of falling back towards the lower part of the saphenous vein. With the saphenous-femoral valvuloplasty you rebuild the valve at the beginning of the saphenous vein so that it can maintain its function, preventing relapse of blood down. With Ambulatory Phlebectomy remove varicose veins and saphenous is maintained, provided that it is appropriate to its function.
When it is indicated the involvement of stripping?Stripping you run in very extensive and severe varicose veins. Small spider veins, and a fortiori in telangiectasias, Sclerosing injections.
What are Sclerosing injections?Injecting, directly into the vein, substances that cause curing and sealing.
The therapy with Sclerosing injections are as effective as surgical?Yes, provided that there are precise and that the intervention is performed by a specialized phlebologist.
What happens to the bloodstream after surgery?The blood returns to the heart through veins more deeper, instead of following the path of the saphenous vein.
After the operation normalizes circulation?Yes, having been eliminated the stagnation that had occurred in varicose veins, circulation returns to normal.
Wearing elastic stockings can heal varicose veins?No; they give only symptomatic relief.
What can happen if left untreated varicose veins?ulcers may form) on the skin of the legs (varicose ulcers);
b) may develop eczema on leg area concerned;
c) may develop a phlebitis;
d) the general health can be adversely affected.
Varicose ulcers and eczema tend to heal after surgery?Yes.
Untreated varicose veins can lead to bleeding through the skin?Yes; from a superficial varicose vein can cause ulcerated heavy bleeding.
What factors are important in deciding whether to intervene surgically in case of varicose veins?pain in the legs) and a general sense of fatigue at the end of a working day;
b) swelling of the legs resulting from the presence of varicose veins;
and incurable ulcer) or chronic eczema;
f) general circulation corruption due to stagnation of blood in the lower legs.
What precautions should you take your surgeon prior to surgery?Must first ensure that the deep circulation is efficient. A very simple test is to apply properly the laces on the limb: If varicose veins are empty means that the circle is valid. A more precise test is the one with the doppler, which measures blood flow in the vessels.
In addition to these tests, before surgery, performs the common blood tests, especially coagulation tests and an electrocardiogram.
It is better to intervene in small varicose veins when disorders do not give?In addition to cosmetic damage, small varicose veins can be harmful from the point of view of cardiovascular and good condition of the limb. Today we tend to always intervene, given the negligible risk and good operating results.
The interventions are painful?No. Sclerosing injections cause an annoyance quite bearable. The big speeches usually are performed under general anesthesia and are not followed by suffering.
Residual scars are blemishes?No. The incisions made in stripping are short and heal well without leaving a clear track. After the surgery, making injections to eliminate any Sclerosing small residual varicose veins and leg regained, plus an excellent circulatory function, also look completely normal.
Varicose veins tend to reappear after surgery?Sometimes, Yes, of course those veins that have not been made. It is evident that the surgery cannot change the natural weakness of venous tissue.
Never forget, however, when intervention is indicated, only because this possibility exists of infrequent rest.