•PA THOLO GY of

BLO OD VESSELS

By: DR. ANTOINETTE T. LEUTERIO

 ARTERIES
• ARTERIOSCLEROSIS
• ARTERITIS
• ANEURYSM
• KAWASAKI DISEASE
• RAYNAUD’S PHENOMENON
 ARTERIOSCLEROSIS
• ATHEROSCLEROSIS
• MONKEBERG ‘S ARTERIOSCLEROSIS
• ARTERIOLOSCLEROSIS
 ATHEROSCLEROSIS
• RISK FACTORS
– hyperlipidemia
– hypertension
• VLDL , HDL
• TYPE IV
• PATHOGENESIS
– Lipid infiltration theory
 ARTERIOLOSCLEROSIS
• Hyaline arteriolosclerosis
(nephrosclerosis of kidneys)
• Hyperplastic arteriolosclerosis
– malignant hypertension

• MONKEBERG’S
ARTERIOSCLEROSIS
(medial calcific sclerosis)
 ARTERITIS
• Polyarteritis nodusa
• Giant cell arteritidis
• Thromboangiitis obliterans
• Wegener’s granulomatosis
GIANT CELL ARTERITIDIS
• Temporal arteritis (skip areas)
• Takayasu’s arteritis (pulseless
disease)
• multinucleate giant cells

POLYARTERITIS NODUSA
group of systemic necrotizing
vasculitides
THROMBOANGIITIS
OBLITERANS
( BUERGER’S DISEASE )
- thrombosis of medium-sized
vessels
(fibrous encasement of artery, vein
& nerve)
WEGENER’S
GRANULOMATOSIS
- necrotizing vasculitis of small
arteries and
witn granulomatous
inflammation
RAYNAUD DISEASE
- paroxysmal pallor or cyanosis of
the digits of hands or feet
RAYNAUD PHENOMENON
- arterial insufficiency of the
extremities

• CONGENITAL
ANOMALIES:
- ARTERIOVENOUS FISTULA
abnormal communication between
artery and vein
 ANEURYSMS
ETIOLOGIC CLASSIFICATION
– Atherosclerotic aneurysm ( most
common)
– Syphilitic aneurysm ( thoracic aorta)
– Dissecting aneurysm (hypertension)

ANATOMIC CLASSIFICATION
– Saccular aneurysm (balloon like-arterial
dilatations)
– Fusiform aneurysm ( spindle- shaped
dilatations)
– Berry aneurysm ( Circle of Willis)
 VEINS
• VENOUS THROMBOSIS
– Thrombophlebitis
– Phlebothrombosis
– Deep venous thrombosis
– Predisposing conditions
venous stasis / hypercoagulable state
( embolization to pulmonary
arteries)
• VARICOSE VEINS
– (superficial veins of lower extremities)
 LYMPHATICS
PRIMARY DISORDERS
– Simple congenital lymphedema
– Heredofamilial lymphedema
( Milroy’s disease )
– Lymphedema praecox

SECONDARY DISORDERS
– Filariasis - (Elephantiasis)
TUMORS of ARTERIES VEINS
& LYMPHATICS
• BENIGN TUMORS
– ANGIOMAS
• Cavernous hemangiomas ( Von Hippel - Lindau
disease)
• Capillary hemangiomas (bleeding)
– GLIOMANGIOMAS (Glomus tumor)
– VASCULAR ECTASIAS (spider telengiectasia)
• OSLER RENDU- WEBER DISEASE

LOW GRADE MALIGNANT TUMOR

– KAPOSI SARCOMA (AIDS)
• MALIGNANT TUMORS
– ANGIOSARCOMA (RARE)
 HYPERTENSION
• DEFINITION
- sustained elevation
- > 140/90 ; 160/ 95
- diastolic pressure
• ETIOLOGY
- Essential hypertension (after age 40)
primary phenomenon
commonest type
familial tendency
due high dietary intake of sodium ( current
theory)
– Secondary hypertension ( under age 40)
due preceding disease
 HYPERTENSION

• MECHANISM of ESSENTIAL HPN (related)

- Primary increase in cardiac output
reduced sodium excretion
- Increase in peripheral resistance
increased vasoconstriction agents
increased sensitivity of vascular smooth
muscles
behavioral or neurogenic factor
- Multiple defects contribute
 HYPERTENSION

• PATHOLOGY
– Benign hypertension
earliest phase, no change
later, hyaline arteriolosclerosis
– Malignant hypertension
diastolic pressure > 110mm Hg
fibrinoid necrosis of media w/ marked
intimal fibrosis
tissues with acute ischemia &
microinfarcts
elevated serum renin levels
 HYPERTENSION
• CLINICAL FEATURES
– Early hypertension
asymptomatic
– Hypertensive heart disease
left ventricular hypertrophy
increased risk of ischemic heart disease
– Hypertensive renal disease
decreased glomerular filtration
progressive glomerular fibrosis
elevation of serum creatinine & hematuria
– Hypertensive cerebral disease
cerebral thrombosis & hemorrhage
hypertensive encephalopathy (headache)
– Hypertensive retinal disease (“ cotton
wool spots “ )
 PATHOLOGY OF THERAPEUTIC
INTERVENTIONS IN VASCULAR
DISEASE
• THROMBOLYSIS
- dissolution of a clot
- plasminogen activators
• BALLOON ANGIOPLASTY AND RELATED
TECHNIQUES
- dilatation of stenosed artery by balloon
catheter
- causes plaque fracture
• VASCULAR REPLACEMENT
- large diameter Dacron grafts perform well
than small dia
• CORONARY ARTERY BYPASS GRAFT SURGERY
 Table 1
TYPES OF HYPERTENSION

• DISEASES
– ESSENTIAL HYPERTENSION ( adult HPN)
– familial
– SECONDARY HPN ( children)
– MALIGNANT HPN ( > 200/140 mm Hg)

• Description
• Causes
• Pathology
 Table 2
MOST COMMON CAUSES &
TYPES
• DISORDER

– Pulmonary embolism
– HPN
– Valvular lesion
 VASCULAR DISEASES
• ANEURYSM
• ARTERIOSCLEROSIS
• HDL
• LDL
• VASCULITIS
 Table 4
ARTERIOSCLEROTIC
DISORDERS
• DISEASES
– MONCKEBERG DISEASE
– ARTERIOSCLEROSIS
– ATHEROSCLEROSIS

• Description
• Risk factors
• Pathology
 Table 5
ANEURYSMS
TYPE
• ATHEROSCLEROTIC ANEURYSM
• SYPHILITIC
• BERRY
• DISSECTING

– Description
– Predisposing factors
– Pathology
 Table 6
OTHER VASCULAR DISEASES

• VARICOSE VEINS
• RAYNAUD DISEASE

– Description
– Risk factors
 Table 7
DISEASES BY VESSEL SIZE

• SMALL VESSELS
• MEDIUM VESSELS
• LARGE VESSELS
 Table 8
TYPES OF VASCULITIS
• DISEASES
– POLYARTERITIS NODOSA
– Hypersensitivity Vasculitis
– Mixed Cryoglobulinemia
– Wegener Granulomatosis
– Buerger disease
– Giant cell Arteritidis
– Kawasaki disease
• Description
• Factors
• Pathogenesis
 Table 9
VASCULAR TUMORS
• BENIGN TUMORS
– HEMANGIOMA
– TELENGIECTASIA
– GLOMANGIOMA
• MALIGNANT TUMORS
– ANGIOSARCOMA
– KAPOSI SARCOMA
 CNS CVS RESP RENAL

SMOKI NG stroke MI

ALCOHOL dementia cardiomyopathy

BURNS Hypo - Volemia

LEAD edema anemia Nephritis