TERMINOLOGY CLINICAL CLARIFICATION
• A rare, nonspecific inflammatory disease that causes aortoarterial stenoses/occlusion or dilatation 2
CLASSIFICATION
• Several systems of classiAcation have been used o By distribution
- The Japanese distribution - typically affects the thoracic aorta and aortic arch with its branches 1
- The Indian distribution- affects the abdominal aorta and the renal arteries 1 o By clinical manifestations phase
- Acute/Active- the associated inflammation causes symptoms such as fatigue, night sweats, anorexia and malaise 2 1
- Chronic/Inactive- symptoms are associated with the organs involved 2• 1 o The 1994 International Conference on Takayasu Arteritis classification 3
- Type 1- involves the aortic branches
- Type
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• Patients with major complications such as severe hypertension, aneurysms, aortic regurgitation and heart Failure and a progressive disease course have a less favorable prognosis
SYNOPSIS
KEY POINTS
• Takayasu arteritis is a nonspecific inflammatory disease that causes aortoarterial stenoses/occlusion or dilatation
• The disease, which is rare in North America, has a higher prevalence among Asian populations and affects mostly young women
• MRI and CT angiography have replaced conventional angiography as the diagnostic tests of choice
• Treatment typically starts with inflammation reduction with corticosteroids, with other immunosuppressants added if there is evidence of progression of vascular disease, re-elevation of inflammatory markers or recurrence of symptoms
• Some patients require surgical treatment such as bypass grafting and percutaneous transluminal angioplasty to treat severe hypertension, stenosis, aneurysms and other complications refractory to treatment
• Most patients respond to immunosuppressive treatment and surgery, but relapse and restenosis are common
• Long-term monitoring with management of persistent hypertension is necessary for all patients
URGENT ACTION
• It is essential to suppress systemic inflammation with pharmacological treatment before performing any other
Unit V- Cardiovascular system Subheading: 1. Cyanotic Congenital Heart Diseases 2. Acyanotic Congenital Heart Diseases 3. Acute Rheumatic Fever 4. Rheumatic Heart Disease 5.
Milton Larsen’s aging body will go through many physiologic changes, specifically the loss of elasticity in the connective tissue. Connective tissue affects many of the body organs through the normal aging process. In the case of Milton Larsen, he is diagnosed with hypertension and osteoarthritis, and both diseases can be associated with loss of elasticity in the connective tissue. Hypertension, termed the “silent killer” affects the cardiovascular system in many ways, with a notably, change in the arteries. The arteries loose elasticity causing a decrease
CHIEF COMPLAINT: Status post ORIF of the tibial plateau on the left. HISTORY OF PRESENT ILLNESS: This patient is new to me. He was treated by Todd Reilly, MD with ORIF. He was seen in followup by David Lin, MD.
Title: What You Need to Know BEFORE Your Knee Replacement Surgery Word Count: 1206 Summary: Here is what should be done in preparation for your knee replacement surgery because you have a lot of questions about the operation. It covers all the small details you need to handle before the surgery, written by a survivor. Keywords: knee replacement surgery, knee replacement, knee surgery, knee replacement procedure, replacing a knee, knee joint replacement, knee surgical equipment, surgery, knee surgery recovery, recovering from knee surgery Article Body: Knee Replacement is pretty scary, but you can do it, especially if you are prepared! After you and your Doctor have decided you need your knee replaced, it’s time to make preparations. First and foremost, check with your insurance company to make sure which benefits you have.
The knee joint is one of the strongest and most important joints in the human body. It allows the lower leg to move relative to the thigh while supporting the body’s weight (Taylor, n.d.) as knee joint is one of the major weights bearing joint in the body. Knee joint plays an important role in our daily lives such as walking, running, sitting and standing. It allows physiological movement such as flexion and extension.
Thoracic Aortic Aneurysm is an abnormal bulging or ballooning of the portion of the aorta the passes through the chest. The most common cause is atherosclerosis, or hardening of the arteries(AHA) Risk factors may include, aging, genetic conditions such as Marfan and Loeys-Dietz Syndrome, Inflammation of the aorta, injury from falls or other trauma, and or, Syphilis. A patient with Thoracic Aortic Aneurysm may not have or experience any symptoms until it begins to leak blood into the nearby tissue or expand. There are many symptoms such as hoarseness, swallowing problems, swelling in neck, chest or upper back pains, and many more to include.
Takayasu Arteritis Takayasu arteritis is a rare condition that may also be called pulseless disease. Takayasu arteritis is caused by inflammation in your large blood vessels (vasculitis). It mainly affects your aorta, which is a large blood vessel that carries blood away from the heart, and the large blood vessels that branch off from it. Areas of the aorta or other affected blood vessels can become narrowed, blocked, or weakened because of the inflammation.
78 y/o female, with dementia, brought in from Plainfield Health Care complaining of all over body pain. Initial EKG demonstrated a STEMI. Patient had no known cardiac history and was known to be a poor historian. Right radial access site was terminated due to complicated vasculature, and consequently femoral access was obtained with placement of a stent to the Distal RCA.
According to research studies, Peripheral artery disease (PAD) had been commonly underdiagnosed, undertreated, and poorly understood. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894725/]. Study result demonstrates that underdiagnosis of PAD in primary care practice may have been the reason for ineffective secondary prevention of the high ischemic cardiovascular risk associated with PAD. The symptoms of Peripheral arterial disease can be mistaken for symptoms of other medical conditions, such as hip pain (a symptom of PAD), is commonly mistaken for arthritis.
Family history and symptoms must be there to confirm diagnosis, and other tests may be performed to determine if the disease is present or not. One of the first tests that would be performed or recommended would be an echocardiogram. This will check to make sure the heart valves and size of the aorta are normal. Computerized tomography or magnetic resonance imaging may be used as well. If someone were to have the disease they will receive regular echocardiograms to monitor the heart.
http://www.annalsthoracicsurgery.org/article/S0003-4975(08)02525-3/fulltext Marco Di Eusanio, Sebastiano Castrovinci, David H. Tian, Gianluca Folesani, Mariano Cefarelli, Antonio Pantaleo, Giacomo Murana, Paolo Berretta, Tristan D. Yan, and Roberto Di Bartolomeo. Antegrade stenting of the descending thoracic aorta during DeBakey type 1 acute aortic dissection repair. Eur J Cardiothorac Surg 2014 45: 967-975. http://ejcts.oxfordjournals.org/content/45/6/967.full Easo J, Weigang E, Holzl PP, Horst M, Hoffmann I, Blettner M, et al.
Best Exercise For Rotator Cuff Injury Don’t be scared if you have a rotator cuff injury. The rotator cuff tear happens to so many people around the world yearly. It is one of the most common causes of shoulder pain. Though it can be a major setback, there are numerous exercises that can help you heal. These workouts listed in this article are the best exercises for rotator cuff pains.
By Jonas Wilson, Ing. Med. Vascular Surgery The surgical branch dealing with disorders of the circulatory system, which includes arteries, veins and lymphatic vessels, is called vascular surgery.
Aberrant right subclavian artery (ARSA) is the most common aortic arch anomaly. The estimated incidence is 0.5-2%. They are often asymptomatic, but approximately 10% of people may complain of dysphagia lusoria4 or other compressive symptoms. In ARSA of the Innominate artery, the right subclavian artery arises as its own branch from the aortic arch distal to the origin of the left subclavian artery. Its relationship to the esophagus is variable with 80% posterior to esophagus, 15% between the esophagus and trachea, and 5% anterior to the trachea.
The 331 patients included in this study were recruited from the outpatient Rheumatology clinic without any selection except fulfilling the ACR classification criteria. They showed characteristics of established RA as shown in Table 1, with an excess of women, advanced age and long time since the start of the first disease symptoms (Data in S1 Table). They were also typical in the fraction showing RA-specific autoantibodies: RF = 60.1 %, anti-CCP = 64.7 % and anti-CarP = 32.9 %, and in the overlap between them (Fig. 1), corresponding with concordances of γ = 0.82 between anti-CCP and RF, 0.66 between anti-CCP and anti-CarP, and 0.64 between RF and anti-CarP (p for all of them < 2.0 x 10-16). The frequency of ever smokers was low (Table 1), but