Inflammatory Vascular Diseases: Definition

00:01 Vascular medicine, advanced inflammatory diseases.

00:06 Inflammatory diseases of the blood vessels can be taken care of by cardiologist or vascular medicine specialists but many of them are related to autoimmune diseases and are often taken care of by rheumatologist or immunologist. A number of them occur in children and are taken care of by pediatricians. For the sake of completeness, I am going to cover all of the inflammatory diseases but note it's important to remember that not all of these will come in the average practice of a vascular medicine physician or cardiologist.

00:41 Well let's start then with the definition. First let's define inflammation. Inflammation is the result of either an infection, for example bacteria or could be a virus, or an injury usually from the immune system or often involving attack by leukocytes who are misinterpreting normal tissue for tissue of an invader. Vasculitis is of course an inflammatory injury in one of the blood vessels. It can occur in the arteries and it can occur in the veins. And in the previous lecture, we have already discussed inflammation in one of these systems, phlebitis.

01:23 Deep venous thrombosis often starts with inflammatory reaction in the vein wall that then goes on to lead to thrombosis and of course eventually pulmonary embolism. In vasculitis of the arterial system and the venous system, its usually involves first the endothelial cells that become attacked or inflamed and then that is followed by inflammation in the smooth muscle layer or the tunica media of the artery or vein. And as I said before arteries and veins can be affected by the one of a variety of inflammatory conditions.

02:03 What are the symptoms? The symptoms are often that of systemic disease. Patients may have fever, weight loss. There may be headache, if one of the blood vessels in the brain is involved, there can be signs of stroke. The patient may have tinnitus or continuous ringing or buzzing in the ear. There may be reduced visual acuity with some visual field loss.

02:27 The skin may show palpable areas of blood collection so called purpura or there may be lots of little lines, little blue lines in the skin so called livedo reticularis.

02:41 The muscles in the joints may be reported as symptomatic with muscle pain or even muscle inflammation and similarly pain in the arthritis are actually signs of swelling in the joints.

02:55 The respiratory tract may be involved with nose bleeding, a bloody cough, or lung infiltrates.

03:01 The GI tract may report abdominal pain, bloody stools, or even a perforated bowel, and the kidneys may develop glomerulonephritis. So again you see, vasculitis is often a systemic disease, affecting blood vessels in all of the body’s organ system and it is therefore a very, very serious condition in many individuals.