Blood Vessel Pathologies;

Aneurysms; are a local dilation of the wall of an artery d/t weakening of that wall. This maybe
caused by a variety of factors including;
- deterioration of the vessel wall as a result of atherosclerosis and arteriosclerosis
- syphilis infections during later stages ( an STD caused by the parasite Treponema)
- congenital defects
- trauma
- other infections
Hypertension ( related to atherosclerosis etc.) us a major promotor of aneurysms but once the
aneurysm is established an elevated BP will make the problem much worse as the increased
pressure inside the artery is exerted outward against the wall causing the dilated area to expand
further. Periods of high stress can even further elevated BP and aggravate the problem even
further. Ultimately it may even cause the aneurysm to rupture .
A large aortic aneurysm can lead to turbulent , disrupted blood flow leading to decreased blood
flow to tissues such as the kidneys and GI etc. as well as increase the risk of thrombus formation
in the arteries and thus lead to peripheral thromboemboli.
Aneurysms of the abdominal aorta, as they expand, may also impinge on and compress adjacent
arteries such as the renal arteries with many negative effects such as renal failure.
Rupture of an aortic aneurysm can be rapidly fatal. Aneurysms in the cerebral circulation can
also be fatal or lead to significant strokes.

Varicose Veins;
are a result of a weakness in the vein walls or of defective one-way valves. They occur most
commonly in dependent areas of the body- especially in the lower limbs or in areas where there
is very little surrounding muscle mass to continue to pump the blood forward through the veins -
eg. the superficial veins of the legs, esophagus and around the rectum ( hemorrhoids).
If some valves are faulty or weak then blood will accumulate over the competent valves and
cause the vessel wall to stretch and expand at this point. This blood accumulation in combination
with the effects of gravity lead to an increase in local hydrostatic pressure which can then
translate back to damage even more valves progressively. The elevated hydrostatic pressure can
then translate back to the capillaries and lead to edema and the static blood flow increases the
risk of thrombus formation. Signs and symptoms include enlarged, bulging purple coloured veins
( esp. if they are superficial [surface]), an aching sensation, muscle fatigue and edema. The
surrounding skin may appear discoloured and shiny and may ultimately ulcerate as it erodes d/t
ischemia.
Risk factors include
- a genetic/ familial predisposition
- trauma
- pregnancy
- thrombophlebitis
Factors that can aggravate the condition may include pregnancy , workplace situations that
involve long periods of standing still, increasing age if it involves a decrease in muscle mass and
physical activity and tight restrictive clothing that impedes venous blood flow.

Thrombophlebitis; involves the formation of a thrombus ( blood clot) in a vein where the vessel
walls are inflamed. Typically the inflammation cases S&S such as heat and redness in the local
surrounding tissues along with a sense of burning, itchiness, aching and tenderness. There may
also be edema as a result of the increased venous pressure and upstream pain. There may also be
systemic S&S such as leukocytosis and fever.

Phlebothrombosis; involves the formation of a thrombus in a vein without the presence of

inflammation to initiate it (ie. it spontaneously forms as a result of stasis of flow associated with
immobility or with CHF or hypocoagulability as a result of dehydration or hypercalcemia).
Initially there will be no local S&S because there is no inflammation. Inflammation may then
developp in the vein as a result. Thrombi that develop this way are less integrated with the
inflammation and so are less firmly attached and more likely to detach and become emboli. From
the venous circulation the clot will circulate through the right side of the heart and enter the
pulmonary circulation where it is likely to become trapped in smaller pulmonary vessels leading
to obstruction. This can lead to respiratory problems such as pneumonia and pulmonary edema
and cardiovascular problems such as heart failure. Common S&S might include sudden chest
pain and cardiogenic shock. This can occur in thrombophlebitis as well but it is much less
common.