Vascular Conditions and Care

The more you know about your vascular condition, the better prepared you’ll be to maintain your heart health. At MacNeal Hospital, we strive to stay up-to-date on the latest diseases and conditions and share our knowledge and expertise with you. Below is information on vascular conditions that we treat and care for at MacNeal Hospital.


Abdominal Aortic Aneurysm (AAA)

Aneurysms often affect the aorta, the body’s largest artery. The aorta carries blood away from the heart through the chest and abdomen. The normal diameter of the aorta in the abdomen is about 2 centimeters. An aneurysm is considered to have formed if the aorta grows to more than 1½ to 2 times its normal diameter.

Aortic aneurysms are potentially serious health problems because a burst aorta results in massive internal bleeding that can be fatal unless treated quickly by an experienced emergency medical team.

Symptoms

  • In some cases, no symptoms will be present.
  • Nausea
  • Pulsating sensation near navel
  • Pain in the back, belly or side

Treatment

In most cases, an aneurysm must be treated right away by an experienced emergency medical team. Surgical repair includes stent and endovascular repair options. In mild cases, your physician may recommend no treatment and will monitor your aneurysm for any changes.

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Buerger’s Disease

Buerger’s disease causes inflammation of the small to medium-sized blood vessels. It usually occurs in the legs and can lead to gangrene.

Symptoms

  • Pain in the extremities
  • Pale skin color of your fingers and toes in cold temperatures (Kayhaud’s Phenomenon)

Treatment

Stopping smoking (for smokers), medication, surgery, compression therapy and amputation in the case of infection or gangrene are all treatments used to treat Buerger’s disease.

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Cardiovascular Disease

A group of heart conditions that includes genetic/structural problems of the heart, blood clots and diseased vessels. Examples include stroke, high blood pressure, heart murmur and others.

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Carotid Artery Disease

A buildup of plaque in the carotid artery.

Symptoms

  • Transient ischemic attack (mini-stroke)
  • Stroke

Treatment

Generally treated by lifestyle changes such as healthy eating, not smoking and increasing your physical activity; surgical interventions are also used. Possible procedures to clear the plaque include stenting procedures, revascularization of subclavian and innominate vessels in preparation for thoracic aneurysm endografting and other bypass procedures.

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Coarctation of the Aorta

A narrowing of the aorta, it slows or blocks blood flow from the heart to the body. Coarctation of the aorta is often associated with other heart defects.

Symptoms

  • In some cases, no symptoms will be present until middle age.
  • Difficulty breathing
  • Enlarged heart
  • Poor appetite

Treatment

No treatment and monitoring is the most common recommendation for mild cases. Surgery can be used to correct defects, especially in more severe cases.

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Coronary Artery Disease

Damage or disease in the heart’s major blood vessels, coronary artery disease (CAD) is the most common form of heart disease in the U.S., affecting more than 17 million people each year. It accounts for more deaths than any other major cause of death in the U.S. and claims more lives than cancer, chronic lower respiratory diseases and accidents combined. (American Heart Association Heart Disease & Stroke Statistics. 2010)

Symptoms

  • In some cases, no symptoms will be present.
  • Chest pain
  • Heart attack

Treatment

Diet and or lifestyle changes, medications and angioplasty or other surgery may be used to treat coronary artery disease. Common surgical treatment is minimally invasive treatment with percutaneous coronary intervention (PCI) such as balloon angioplasty or stenting. Less common is a coronary artery bypass graft (CABG).

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Coronary Thrombosis

A blood clot in a blood vessel inside the heart, a coronary thrombosis restricts blood flow.  There is an increased risk for smokers, and can also be a complication of drug-eluting stents.

Symptoms

  • Pain on exertion

Treatment

Surgery to remove blockage.

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Deep Vein Thrombosis (DVT)

A blood clot in a deep vein can be a serious condition that needs expert treatment. Deep vein thrombosis, or DVT, can be treated in a number of ways.

Symptoms

  • In some cases, no symptoms will be present.
  • Pain in the calf, foot and/or leg
  • Tenderness and warm skin
  • Swelling in the extremities

Treatment

Deep vein thrombolysis is an endovascular procedure designed to rapidly break up a blood clot and restore blood flow. It may also preserve valve function in blood vessels. If the vein appears narrowed, the radiologist may also perform a balloon angioplasty or stent placement to widen the vessel and help prevent future blockages. Other treatments may include placement of a vena cava filter or a procedure called a venous thrombectomy.

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Familial Hypercholesterolemia

Familial Hypercholesterolemia is a genetic disorder that causes increased levels of LDL (bad) cholesterol. It is caused by a defect on chromosome 19.

Symptoms

  • Chest pain
  • Cholesterol deposits in your eyelids (xanthelasmas)
  • Coronary artery disease at a young age
  • Fatty skin deposits (xanthomas)
  • Sores and wounds on your feet that do not heal
  • Sudden stroke-like symptoms

Treatment

Lifestyle changes and medications are the normal course of treatment.

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Hyperlipidemia

Hyperlipidemia is the increased levels of lipids, or fat particles, in the blood. It is diagnosed with blood tests.

Symptoms

  • In some cases, no symptoms will be present.

Treatment

Medication and lifestyle changes, such as a healthy diet and increased physical activity.

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Hypertension

Commonly called high blood pressure, hypertension can cause other health conditions. High blood pressure can be made worse by a lack of physical activity, smoking and an unhealthy diet full of salt and processed fatty foods.

Symptoms

  • In some cases, no symptoms will be present.
  • Dizziness
  • Headaches
  • Nausea
  • Nosebleeds

Treatment

Diet and/or lifestyle changes, medications and increased exercise are all treatments for hypertension.

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Inflammatory Vasculitis

An inflammation, or swelling, of the blood vessels including arteries, veins and/or capillaries. Inflammatory vasculitis causes blood vessels to weaken and/or narrow, often leading to a blockage. The condition can be caused by multiple factors, including autoimmune diseases, as well as a side effect of some medications.

Symptoms

  • Abdominal pain
  • Arthritis
  • Bloody cough
  • Dark or purple colored spots on your skin
  • Fever
  • Gangrene
  • Headache
  • Hypertension
  • Stroke
  • Weight loss

Treatment

Corticosteroids, immunosuppression therapy and antibiotics are all common treatments. If any organs are damaged as a result of the vasculitis, they may require additional treatment.

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Kawasaki Disease

A short-term disease, Kawasaki disease causes inflammation in the walls of the blood vessels.

Symptoms

  • Diarrhea
  • Fever
  • Joint pain
  • Peeling skin
  • Rash
  • Vomiting

Treatment

Aspirin is commonly used as an initial treatment. Other treatments include immunoglobulin therapy or other medications.

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Lymphedema

Lymphedema is a swelling in the extremities that is caused by a blockage in the lymphatic system.

Symptoms

  • Swelling of arms and/or legs
  • Pain and/or discomfort, especially in arms and/or legs

Treatment

Exercise, massage and the use of compression stockings and/or wraps are the most common treatment.

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May-Thurner Syndrome

Also known as iliac vein compression syndrome, May-Thurner syndrome it is a rare condition that causes blood clots and deep vein thrombosis (DVT).

Symptoms

  • Pain in legs
  • Swelling of legs

Treatment

Treatment varies depending on the underlying cause of the disease. It is recommended that patients receive evaluation by a vascular specialist.

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Mesenteric Ischemia

Also known as mesenteric vascular disease, mesenteric ischemia is an injury of the small intestine due to a lack of blood supply. It can be sudden or gradual, developing over time into one of the three stages: hyperactive, paralytic and shock.

Symptoms

  • Abdominal pain
  • Abdominal bloating
  • Bloody stools
  • Systemic shock (dehydration, decreased blood pressure, rapid heart rate, confusion)

Treatment

Treatment usually includes anticoagulation medications to prevent clots that would block blood flow to the small intestine. In some cases, surgery is required to remove a blockage.

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Paget-Schroetter Syndrome

Paget-Schrötter syndrome is a type of deep vein thrombosis (DVT) that involves blood clots forming in the arms. These clots usually form in two specific veins, known as axillary and subclavian veins. It is important to treat the blood clots, as they can break free and move from the arm to other locations in the body, possibly causing life-threatening issues, such as a pulmonary embolism. The disease is more common in younger males.

Symptoms

  • Pain
  • Redness/blueness of the skin
  • Swelling in your arms
  • Warmth

Treatment

Anticoagulation medications are a common approach, followed by surgery, when necessary, to clear the blockage.

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Peripheral Aneurysm

A peripheral aneurysm is a swelling or abnormality of a blood vessel that is not your aorta.

Symptoms

  • Gangrene
  • Pain, especially with exercise
  • Painful sores or ulcers on your toes and/or fingers
  • Pulsating lump

Treatment

Lifestyle changes, medications and surgery to reinforce vessel walls may all be used.

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Peripheral Artery Disease/Peripheral Vascular Disease (PAD/PVD)

Peripheral artery disease (PAD), also known as peripheral vascular disease (PVD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels - the arteries, veins, or lymphatic vessels. Arteries are the blood vessels that deliver oxygen-rich blood and nutrients from the heart to the tissues of the entire body. In patients with PAD/PVD, neither the oxygen nor the nutrients can get to the legs, arms and organs.

Conditions associated with PAD/PVD may occur because the artery becomes blocked in some manner (oclusive) or the artery constricts due to a spasm or expands (functional). Examples of occlusive PAD/PVD include peripheral arterial occlusion and Buerger's disease (thromboangiitis obliterans). An example of functional PAD includes Raynaud's disease and phenomenon.

One in every 20 Americans over the age of 50 has PAD/PVD, a condition that develops when fatty deposits that limit blood flow to the legs and increase the risk for a heart attack or stroke. Men and women are equally affected by PAD/PVD, although African-Americans have an increased risk.

Symptoms

  • Cold or numb toes
  • Decreased or absent pulses in the feet
  • Hair loss on legs
  • Leg pain with physical activity (goes away with rest)
  • Muscle loss (atrophy)
  • Non-healing ulcers or sores on the legs or feet
  • Skin that is cool to the touch, especially when accompanied by pain while walking
  • Smooth, shiny skin on legs

If you are experiencing any of these symptoms, DO NOT WAIT. Talk to a doctor. If you do not have a doctor, call 877-834-7264.

Treatment

There are options for treatment. Understanding and modifying risk factors is an important part of treating PAD/PVD. A risk factor is anything that may increase your chance of developing a disease, and can be changeable or unchangeable. Changeable risk factors include coronary artery disease, impaired glucose tolerance, dyslipidemia, hypertension, obesity, physical inactivity and smoking or use of tobacco products. In the case of PAD/PVD, unchangeable risk factors include age, family or personal history of heart disease, male gender, type 1 diabetes (diabetes mellitus), postmenopausal women and a family history of dyslipidemia, hypertension or peripheral vascular disease.

Treatment can also involve a number of surgical options, including femoral popliteal bypass surgery, femoral popliteal stenting, femoral popliteal balloon angioplasty, thrombolytic therapy, minimally invasive atherectomy, or other vascular surgery.

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Renal Artery Stenosis

Renal artery stenosis is the narrowing of kidney arteries. This condition causes high blood pressure and may eventually lead to kidney failure. The largest risk factor is uncontrolled high blood pressure.

Symptoms

  • In some cases, no symptoms will be present.

Treatment

Medications are a common treatment. If necessary, surgery can be used to widen the arteries.

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Renal Vein Thrombosis

Renal vein thrombosis is a blood clot blocking a vein in the kidney. Blood clots in renal veins are uncommon and rarely affect the kidney, but they can sometimes travel to and lodge in arteries supplying the lungs, causing a dangerous condition called a pulmonary embolism.

Symptoms

  • Blood in the urine
  • Difficulty breathing
  • Enlarged kidney
  • Fever, nausea, or vomiting
  • High blood pressure
  • Pain in the sides of the abdomen, legs, or thighs
  • Protein in the urine
  • Sudden, severe leg swelling

Treatment

Anticoagulant medications are the treatment of choice, but in some cases surgery may be necessary.

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Syncope

Syncope is a temporary loss of consciousness and muscle tone caused by inadequate blood supply to the brain. The common reason behind each syncope or fainting episode is a temporary lack of oxygen-rich (red) blood getting to the brain. However, many different problems can cause a decrease in blood flow to the brain. Some causes of syncope include:

  • Heart disease – Rarely, there are abnormalities of the heart that can cause syncope episodes. Heart defects causing "outflow obstruction" may produce fainting because they restrict the blood flow to the body and brain.  
  • Irregular or rapid heart rhythms can also trigger syncope. When the heart beats rapidly or irregularly, the ventricles have less time to fill with blood, and the body reacts to the diminished blood flow to the brain by fainting.
  • Myocarditis – Inflammation of the heart muscle, known as myocarditis, weakens the heart muscle so it is not able to pump normally. The body again reacts to decreased blood flow to the brain by fainting.
  • Orthostatic hypotension – This is a drop in blood pressure that occurs when a person has been standing for a while, or changes from a sitting to a standing position. Blood pools in the legs, preventing a normal amount of blood from being pumped to the brain. This momentary drop in blood flow to the brain causes a person to faint.
  • Vasovagal syncope – This is the most common type of syncope. A variety of situations stimulate the vagus nerve, which leads to a slowing of the heart rate and dilation of the body's blood vessels. With a slow heart rate and dilated blood vessels, less blood gets to the brain, and fainting occurs. Pain and emotional stress can trigger vasovagal syncope in susceptible people. This type of syncope can happen more often in some families.

Other situations or illnesses that can cause syncope include, but are not limited to, head injury, seizure, stroke, inner ear problems, dehydration, low blood sugar, breath holding episodes in young children, pregnancy and anemia.

Symptoms

  • Clammy skin
  • Cold sweat
  • Fainting
  • Presyncope (feeling faint or dizzy)

Treatment

Specific treatment will be determined by your healthcare provider based on a medical history and physical exam. Staying hydrated and maintaining a good diet can prevent future episodes. When you feel faint, try lying or sitting down with your head lower than your heart. If there is an underlying condition that is causing the syncope (such as heart disease), you may be referred to a specialist, such as a cardiologist, for medication and further evaluation.

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Thoracic Aortic Aneurysm

An aneurysm of the thoracic aorta is a serious condition that needs prompt medical attention. Aneurysms often affect the aorta, the body’s largest artery. The aorta carries blood away from the heart through the chest and abdomen. As the blood vessel expands it can rupture or burst.

Symptoms

  • In some cases, no symptoms will be present.
  • Pain in the jaw, neck, upper back or chest
  • Coughing or difficulty breathing

Treatment

Your physician may prescribe no treatment, instead monitoring the size of your aneurysm for any changes. Surgical repair is possible, preferably with a stent-graft.

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Thoracic Outlet Syndrome

A group of disorders involving compression of blood vessels or nerves.

Symptoms

  • Pain in the shoulders and/or neck
  • Tingling or numbness in fingers

Treatment

Pain relief can come with physical therapy and over the counter medications, such as ibuprofen. Surgery is an option, though not needed in most cases.

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Total Anomalous Pulmonary Venous Return (TAPVR)

A rare congenital defect, TAPVR causes the four pulmonary veins to connect and drain into the right atrium of the heart instead of the left atrium of the heart. It is most commonly diagnosed soon after birth, though in mild cases a child may show signs later in life.

Symptoms

  • Newborns with TAPVR are very ill from birth and may have blue skin (cyanosis).
  • Older children will show signs of a heart murmur.

Treatment

Surgery is needed to correct the defect.

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Transposition of the Great Arteries

A congenital heart defect, transposition of the great arteries changes how blood moves through the body by switching (transposing) the two main arteries that leave the heart.

Symptoms

  • Blue tint to the skin (cyanosis)
  • Lack of appetite
  • Poor weight gain in infants
  • Shortness of breath

Treatment

Medication can be used to reduce symptoms until surgery can be performed to correct the defect.

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Truncus Arteriosus

A defect in which the aorta and pulmonary artery do not form separately. Instead, a large artery, called the truncus, comes from the heart. As the truncus leaves the heart, it may branch into arteries that carry blood to the body and to the lungs.

Symptoms

  • Blue tint to the skin (cyanosis)
  • Clubbed fingers/toes
  • Fatigue
  • Rapid breathing
  • Shortness of breath

Treatment

Surgery is required to correct the defect.

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Varicose Veins

Enlarged, bumpy veins; usually in the legs and/or feet.

Symptoms

  • In some cases, no symptoms will be present.
  • Discomfort
  • Pain

Treatment

Compression stockings, exercise and surgical procedures are all used to treat varicose veins.

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Vascular Ring

A vascular ring is a congenital defect that causes normal vessels to appear in an abnormal location. It can compress or block the esophagus and/or airway.

Symptoms

  • Difficulty breathing
  • Noisy breathing
  • Trouble swallowing

Treatment

Surgery is required to repair the defect.

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Venous Insufficiency

More common in the legs and/or feet than in other parts of your body, venous insufficiency is the inability of your veins to circulate the blood efficiently.

Symptoms

  • Aching and/or cramping in legs
  • Pain in the legs
  • Swelling in the legs
  • Ulcers or slow healing wounds on the legs and/or ankles
  • Varicose veins

Treatment

Compression stockings, exercise, maintaining a healthy weight, and surgical and other medical interventions can all be used to treat venous insufficiency. Surgical intervention may include ablation or angioplasty.

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