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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
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Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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To obtain accurate blood pressure measurements in clinical settings, especially when traditional methods are insufficient, healthcare professionals utilize the Doppler ultrasound technique. This method uses high-frequency sound waves to detect blood flow within the arteries, which is crucial for patients with conditions that complicate circulatory system assessment.
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
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Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
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More Tools for Evaluating Decidual Artery Disease.

Mercedes Olaya-C1, Jorge A Franco Zuluaga2

  • 1Department of Pathology, Institute of Human Genetics, the Medical School, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia.

International Journal of Surgical Pathology
|December 6, 2022
PubMed
Summary

Hypertensive disorders of pregnancy are linked to abnormal spiral artery remodeling in the placenta. Further study of these placental changes can aid in understanding and diagnosing preeclampsia.

Keywords:
decidual arteriopathypreeclampsiaspiral arteriesvascular remodeling

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Area of Science:

  • Obstetrics and Gynecology
  • Pathology
  • Maternal-Fetal Medicine

Background:

  • Hypertensive disorders of pregnancy present significant risks to maternal and neonatal health.
  • Decidual artery disease, characterized by abnormal vascular remodeling, is a common histological finding and a key aspect of preeclampsia pathophysiology.

Purpose of the Study:

  • To investigate the frequency and characteristics of spiral artery abnormalities in pregnancies with hypertensive disorders.
  • To explore the role of persistent parietal trophoblast lining and acute inflammation as potential factors in decidual arteriopathy.

Main Methods:

  • Analysis of 720 consecutive placenta case studies adhering to the Amsterdam consensus.
  • Collection of maternal and neonatal clinical data alongside placental findings on spiral artery abnormalities.
  • Evaluation of decidual arteriopathy criteria, including persistent parietal trophoblast lining and acute inflammation.

Main Results:

  • Thirty percent of the study population developed hypertensive disorders of pregnancy.
  • A high frequency of arterial remodeling abnormalities was observed in placentas from pregnancies with hypertensive disorders.
  • Persistent parietal trophoblast lining was noted as a frequent finding alongside expected arterial abnormalities.

Conclusions:

  • Spiral maternal artery remodeling requires further investigation for a comprehensive understanding of its role in pregnancy complications.
  • Abnormalities in spiral artery remodeling serve as an objective marker for studying and diagnosing pregnancy complications like preeclampsia.
  • Altered spiral artery remodeling reflects early pregnancy alterations and is intrinsically linked to the etiology of preeclampsia.