Interstroke Study published in the Lancet identified that 10 risk factors caused 88-90% of all strokes (both hemorrhagic and ischemic).
1. Hypertension
2. Current smoking
3. Low waist to hip ratio
4. Unhealthy diet
5. Lack of regular exercise
6. Moderate or high alcohol intake
7. Psychosocial stress
8. Depression
9. High ratio of apoB to apoA1 lipoprotein (i.e. high cholesterol)
10. Diabetes
Reference: Interstroke Study, Lancet
(Double click any word for definition)
Also known as Buerger’s Disease (not to be confused with Berger’s disease which is IgA nephropathy)
Small – medium sized blood vessels involved
Strongly linked to tobacco use – smoking (both active and passive) and nicotine patches
Unclear etiology
More common in men than women (3:1)
Typical age group 20 – 45 years
Clinical Features
Diagnosis of exclusion
Typically age is < 45 years
Current or history of tobacco use
Presence of distal extremity ischemia (indicated by claudication, pain at rest, ischemic ulcers, or gangrene) documented by noninvasive vascular testing
Consistent arteriographic findings in the clinically involved and noninvolved limbs
Patients may describe a Raynaud type phenomenon in hands or fingers
Superficial migratory thrombophlebitis may occur
Parasthesias of hands & feet with impaired distal pulses (proximal pulses are generally normal)
Allen test may be positive
Workup
Labs are typically geared towards ruling out other causes
Angiography – may be required in all limbs as TAO may be clinically silent
Typical angiography features include:
Echo should always be performed to rule out embolic source
Treatment
Absolute discontinuation of tobacco use
Symptomatic management
Surgical options:
Cholesterol is a normal constituent of the human body. However excess cholesterol (hypercholesterolemia or sometimes called dyslipidemia) is one of the most important risk factors for developing heart attack and stroke.
Here are a couple of videos on cholesterol explaining why is cholesterol important to the body, how it causes disease and what lifestyle changes are required to decrease excess cholesterol.
What does high cholesterol do? (Time 4:11 min)
Lifestyle changes for high cholesterol (Time 7:40 min)
Animated video explaining how coronary angioplasty with stent insertion is performed. Also called percutaneous coronary intervention (PCI), it is the procedure of choice for most cases of heart attack.
Coronary artery bypass grafting is performed for severe disease as in involvement of all 3 coronary vessels or left main coronary artery.
This presentation gives a brief overview of Pulmonary Embolism. It was presented by my co-resident Maria Teresa Bejarano, MD as part of new intern lecture series.
RSS subscription
| We comply with the HONcode standard for trustworthy health information: verify here. |
