Final: 534: Cardio Wk 7 PII

What is the pathology behind varicose veins?

• Dilated, bulging, tortuous superficial veins

• >3mm diameter

What is the difference between dilated intradermal veins and telangiectasias?

dilated intradermal veins

• blue-green

• measure 1-3 mm in diameter

• No protrusion

Telangiectasias

• Small at <1 mm in diameter

• Dilated

• spider-web pattern

What is the difference between primary and secondary varicose veins?

Primary

• Origin in superficial system and 50% has + FMHX

  • Defective structure/function of valves of saphenous veins

  • Intrinsic weakness of vein wall

  • High intraluminal pressure

Secondary

• 2nd to HTN, deep-venous insufficiency or deep-venous obstruction

  • → incompetent perforating veins → enlarged superficial veins

• Ex: arteriovenous fistulas - varicose veins in limbs

Define chronic venous insufficiency

Consequence of incompetent veins →:

• venous HTN

• extravasation of fluid

  • blood in tissues of limb

What are some causes to chronic venous insufficiency?

• varicose veins

• disease in deep veins

What is the difference between primary and secondary chronic venous insufficiency

Primary

• consequence intrinsic structural/functional abnl in vein wall or venous valves → valvular reflux/regurg.

Secondary

• obstruction and/or valvular incompetence from previous deep-vein thrombosis.

What else can cause 2nd varicosities?

R-sided heart disease

Define atrial septic defect (ASD)

• Left-to-right shunt

• Intracardiac holes that allows blood to transmit between chambers or spaces

• Size determines R sided dilation

What is the difference between secundum ASD and primum ASD?

Secundum

• MC

• Occurs at fossa ovalis

Primum

• Deficiency of AV canal portion of atrial septum

• Always ass w/ abnl development of AV valves w

  • MC: cleft in mitral valve

both fixed by sx