• Congenital abnormalities of the vessels

    by  • 10/09/2013 • Cardiology

    Arteriovenous fistula

    Abnormal communication between an artery and vein

    Origin:

    1. Primary = congenital
      1. o Secondary = trauma, inflammation or healed ruptured aneurysm

     

    1. Fistulas may cause shunting of blood, bypassing circulations and increasing venous return, therefore increasing cardiac output.
    2. May predispose to heart failure.
    3. May be seen in Pagets disease of the bone, where increased blood flow through bones may eventually lead to heart failure.

     

    Berry aneurysm

    1. Found in 2% postmortems
    2. Most common intracranial aneurysm
    3. Small saccular aneurysms in the cerebral vessels
    4. Frequently occur at branch points in the circle of Willis.
    5. Commonly seen in patients with coarctation of the aorta and polycystic renal disease.
    6. Asymptomatic until they rupture.

     

    Predisposing factors to rupture:

    1. Smoking
    2. Hypertension
    3. Atheroma

     

    When they rupture:

    1. More common in males.
    2. Sudden onset of severe headache.
    3. Rupture leads to subarachnoid haemorrhage (p/c: severe occipital ‘thunderclap’ headache, vomiting, confusion, reduced/LOC, causes 1-7% of all strokes). 
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