Terms & Procedures FAQ's

A
Q: What is an aneurysm?
A: An aneurysm is a balloon-like bulge in a blood vessel that can affect any large vessel in your body. An aneurysm happens when the pressure of blood passing through part of a weak blood vessel forces the vessel to bulge outward, forming what you might think of as a thin-skinned blister. Not all aneurysms are life threatening, but those found in the arteries in our bodies often need to be treated. If the bulging stretches the artery too far, this vessel may burst, causing a person to bleed to death. Aneurysms can occur in blood vessels anywhere in the body. They usually form in the brain or in the aorta (the main artery carrying blood from the heart). In many cases, aneurysms are associated with other types of cardiovascular disease, especially high blood pressure and atherosclerosis. Traumatic injuries, infections, and congenital conditions can also lead to an aneurysm.
Q: What is angina?
A: Heart pain (angina) is a discomfort caused by a narrowed coronary artery. An adequate amount of blood and oxygen is unable to reach the heart muscle and symptoms occur. You may have heard "chest pain" used to describe these symptoms, but the discomfort may not occur in the chest and it may not be experienced as pain. Therefore, we prefer to use the term "angina". Angina is a warning signal and does not always mean a heart attack is occurring. Angina may occur in many different locations: chest, arms, shoulders, neck, back, or jaw. It may feel like pressure, burning, squeezing, fullness, tightness, aching, crushing, heaviness, or dull discomfort. Your only symptom may also be extreme fatigue. If the coronary artery is narrowed but not blocked, the angina may be of brief duration and relieved by rest and/or nitroglycerine. If the coronary artery is completely blocked and a heart attack is occurring, the discomfort may wax and wane, but it will always come back. Rest and/or nitroglycerine will not relieve it, and you may also experience sweating, nausea and/or vomiting, shortness of breath, weakness, or fainting. Many people describe angina that mimics gastrointestinal (GI) distress. If the discomfort can be relieved by an antacid and does not return, it is most likely not angina. After heart surgery, people sometimes have difficulty telling the difference between chest wall/incisional pain and angina. Incisional discomfort varies from person to person. it may be described as an aching or throbbing sensation or as a sharp pinprick like pain. The discomfort is often brief and can be brought on by movement. If you can reproduce the discomfort by pressing on the area where it occurs, it is most likely chest wall or muscular pain. Pain medications and/or a change in position will usually relieve this type of discomfort. If you are unsure of the type of pain you are experiencing, you should consult your physician. If the discomfort is at all like your symptoms of angina, take your Nitroglycerine if you have been instructed to do so, or call 911.
Q: What is an angioplasty?
A: Angioplasty (AN-jee-oh-plas-tee) is a medical procedure used to restore blood flow through a narrowed or blocked artery in the heart. The arteries of the heart (the coronary arteries) can become narrowed and blocked due to buildup of a material called plaque on their inner walls. This narrowing reduces the flow of blood through the artery and can lead, over time, to coronary artery disease and heart attack. In angioplasty, a thin tube with a balloon or other device on the end is first threaded through a blood vessel in the arm or groin (upper thigh) up to the site of a narrowing or blockage in a coronary artery. Once in place, the balloon is then inflated to push the plaque outward against the wall of the artery, widening the artery and restoring the flow of blood through it.
Q: What is aortic valve stenosis?
A: This is a defect of the aortic valve in the heart that often causes it to open incompletely. This reduces blood flow to the body.
Q: What is an arrhythmia?
A: Arrhythmias are irregular heartbeats caused by a disturbance in the electrical activity that paces your heartbeat. Arrhythmias cause nearly 250,000 deaths each year. Almost everyone's heart skips a beat at one time or another. These mild, one-time palpitations are harmless. But there are more than 4.3 million Americans who have recurrent arrhythmias, and these people should be under the care of a doctor. Arrhythmias can be divided into two categories: ventricular and supraventricular. Ventricular arrhythmias happen in the heart's two lower chambers, called the ventricles. Supraventricular arrhythmias happen in the structures above the ventricles, mainly the atria, which are the heart's two upper chambers. Arrhythmias are further defined by the speed of the heartbeats. A very slow heart rate, called bradycardia, means the heart rate is less than 60 beats per minute. Tachycardia is a very fast heart rate, meaning the heart beats faster than 100 beats per minute.
Q: What is atherosclerosis?
A: Atherosclerosis is a condition where a waxy substance forms inside the arteries that supply blood to your heart. This substance, called plaque, is made of cholesterol, fatty compounds, calcium, and fibrin (a blood-clotting material). Scientists think atherosclerosis begins when the very inner lining of the artery (the endothelium) is damaged. High blood pressure, high levels of cholesterol, fat, and triglycerides in the blood, and smoking are believed to lead to the development of plaque. Atherosclerosis may continue for years without causing symptoms.
Q: What is atrial fibrillation?
A: Atrial fibrillation is a fast, irregular rhythm where single muscle fibers in your heart's upper chambers twitch or contract. According to the American Heart Association (AHA), atrial fibrillation is a major cause of stroke, especially among older people. This irregular rhythm may cause blood to pool in the heart's upper chambers. The pooled blood can lead to clumps of blood called blood clots. A stroke can occur if a blood clot travels from the heart and blocks a smaller artery in the brain (a cerebral artery).
Q: What is an atrial septal defect?
A: An atrial septal defect (ASD) is a hole in the wall (septum) that separates the two upper chambers (atria) of the heart. The defect allows blood to flow from one atrium to the other, usually from the left side to the right side. This causes extra blood flow in the right atrium, the right ventricle and to the lungs.
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Q: What is bacterial endocarditis?
A: Bacterial endocarditis (BE) is an infection of the valves and inner lining of the heart (called the endocardium). It happens when bacteria from the skin, mouth or intestines enter the bloodstream and infect the heart valves and lining.
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Q: What is cardiac catheterization?
A: Cardiac catheterization is the method doctors use to perform many tests available for diagnosing and for treating coronary artery disease. Cardiac catheterization is used with other tests such as angiography and electrophysiology studies (EPS). The method involves threading a long, thin tube (called a catheter) through an artery or vein in the leg or arm and into the heart. Depending on the type of test your doctor has ordered, different things may happen during cardiac catheterization. For example, a dye may be injected through the catheter to see the heart and its arteries (a test called angiography), or electrical impulses may be sent through the catheter to study irregular heartbeats (tests called electrophysiology studies).
Q: What is a cardiologist?
A: A cardiologist is a physician who is certified to treat problems of the cardiovascular systemčthe heart, arteries, and veins. Cardiology is classified as an internal medicine subspecialty. Knowledge of internal medicine and other specialties is required to obtain certification.
Q: What is cardiomyopathy?
A: Cardiomyopathy is any disease of the heart muscle in which the heart loses its ability to pump blood effectively. In some instances, heart rhythm is disturbed and leads to arrhythmias (irregular heartbeats). There may be multiple causes of cardiomyopathy, including viral infections. Sometimes, the exact cause of the muscle disease is never found.
Q: What is carotid artery disease?
A: Carotid artery disease is a form of disease that affects the vessels leading to the head and brain (cerebrovascular disease). Like the heart, the brain's cells need a constant supply of oxygen-rich blood. This blood supply is delivered to the brain by the 2 large carotid arteries in the front of your neck. If these arteries become clogged or blocked, you can have a stroke. Carotid artery disease is usually caused by atherosclerosis, which is a hardening and narrowing of the arteries. As we age, fat deposits, cholesterol, calcium, and other materials build up on the inner walls of the arteries. This build-up forms a wax-like substance called plaque. As the plaque builds up, the arteries become narrower, and the flow of blood through the arteries becomes slower. Lifestyle changes, medicines, transcatheter interventions, or surgery can be used to treat carotid artery disease and lower your risk of a stroke.
Q: What is cholesterol and why is it so important?
A: Cholesterol is a fat-like substance (lipid) found in all body cells. Your liver makes all of the cholesterol your body needs to form cell membranes and make certain hormones. Extra cholesterol enters your body when you eat foods that come from animals (meats, eggs, and dairy products). Although we often blame the cholesterol found in foods that we eat for raising blood cholesterol, the main culprit is saturated fat, which is also found in our food. So, we should limit foods high in cholesterol or saturated fat. Foods rich in saturated fat include butter fat in milk products, fat from red meat, and tropical oils such as coconut oil. Cholesterol travels to cells through the bloodstream in special carriers called lipoproteins. Two of the most important lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Doctors look at how LDL and HDL relate to each other and to total cholesterol. LDL particles deliver cholesterol to your cells. LDL cholesterol is often called "bad cholesterol" because high levels are thought to lead to the development of heart disease. Too much LDL in the blood causes plaque to form on artery walls, which starts a disease process called atherosclerosis. When plaque builds up in the coronary arteries that supply blood to the heart, you are at greater risk for having a heart attack. HDL particles carry cholesterol from your cells back to your liver, where it can be eliminated from your body. HDL is known as "good cholesterol" because high levels are thought to lower your risk for heart disease.
Q: What is coronary artery disease?
A: Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle (coronary arteries) become hardened and narrowed. The arteries harden and become narrow due to the buildup of plaque on the inner walls or lining of the arteries (atherosclerosis). Blood flow to the heart is reduced as plaque narrows the coronary arteries. This decreases the oxygen supply to the heart muscle. CAD is the most common type of heart disease. It is the leading cause of death in the U.S. in both men and women.
Q: What is coronary bypass surgery?
A: Bypass surgery improves the blood flow to the heart with a new route, or "bypass," around a section of clogged or diseased artery. The surgery involves sewing a section of vein or artery from the leg or chest (called a graft) to bypass a part of the diseased coronary artery. This creates a new route for blood to flow, so that the heart muscle will get the oxygen-rich blood it needs to work properly. Coronary bypass surgery has proved safe and effective for many patients who have the procedure. You can expect to stay in the hospital for about a week after surgery, including at least 1 to 3 days in the Intensive Care Unit (ICU). Your doctor may also recommend that you participate in a cardiac rehabilitation program. These programs are designed to help you make lifestyle changes like starting a new diet and exercise program, quitting smoking, and learning to deal with stress.
Q: What is a CT scan?
A: A computerized tomography (CT) scanner is a special type of X-ray machine used to produce pictures of the inside of the body. Unlike an ordinary X-ray, which is developed on film, a CT scan creates images of "slices" of the body on a computer screen. The images are black, white and grey, like ordinary X-rays, but are much more detailed and can even be viewed in three dimensions. Depending on the part of the body being examined, a dye (contrast medium) may be used to make some tissues show up more clearly.
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Q: What is deep vein thrombosis (DVT)?
A: Deep vein thrombosis (DVT) occurs when a blood clot develops in a vein deep in the body. Deep veins are found within groups of muscles. The veins close to the skin are called superficial veins. While DVT most often develops in the lower legs or thighs, they may appear in the upper body, such as the arms or other locations in the body. It is estimated that there are more than 2.5 million persons in the US who develop deep vein thrombosis each year. Deep vein thrombosis can pose a serious threat to health. Pieces of a clot can break off and travel through the bloodstream to the lung. This is called a pulmonary embolism and can be fatal soon after it occurs. Deep vein thrombosis can also block blood flow in the veins, causing the blood to pool. This can cause swelling, pain, and permanent damage to the leg called post-thrombolic syndrome.
Q: What is diabetes?
A: Diabetes is a disease that occurs when a person’s body doesn’t make enough insulin or can’t use insulin properly. When you have diabetes, the sugar builds up in your blood instead of moving into the cells. Some, but not all, of the excess sugar is carried out of your body (through urine), and the energy is wasted. There are two types of diabetes. Type 1 occurs when the body doesn't produce any insulin. People with type 2 diabetes either don't produce enough insulin or their cells ignore the insulin. Nearly 95% of people with diabetes have type 2.
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Q: What is Ebstein's anomaly?
A: Ebstein's anomaly is a defect where the tricuspid valve is both displaced and abnormally formed. The valve is leaky and allows blue blood to flow back into the right atrium instead of to the lungs to pick up oxygen.
Q: What is Ejection Fraction?
A: The ejection fraction is a measurement of the heart's efficiency and can be used to estimate the function of the left ventricle, which pumps blood to the rest of the body. The left ventricle pumps only a fraction of the blood it contains. The ejection fraction is the amount of blood pumped divided by the amount of blood the ventricle contains. A normal ejection fraction is more than 55% of the blood volume. If the heart becomes enlarged, even if the amount of blood being pumped by the left ventricle remains the same, the relative fraction of blood being ejected decreases. For example: A healthy heart with a total blood volume of 100 mL that pumps 60 mL to the aorta has an ejection fraction of 60 percent. A heart with an enlarged left ventricle that has a total blood volume of 140 mL and pumps the same amount (60 mL) to the aorta has an ejection fraction of 43 percent.
Q: What does the term "enlarged heart" mean?
A: An enlarged heart means the heart is larger than normal due to heredity, or disorders and diseases such as obesity, high blood pressure, and viral illnesses. Sometimes doctors do not know what makes the heart enlarge.
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Q: What is a heart attack?
A: A heart attack occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a clot in a coronary artery. Often, this blockage leads to arrhythmias (irregular heartbeat or rhythm) that cause a severe decrease in the pumping function of the heart and may bring about sudden death. If the blockage is not treated within a few hours, the affected heart muscle will die and be replaced by scar tissue.
Q: What is heart failure?
A: Heart failure, also referred to as congestive heart failure (CHF), is a condition where the heart cannot pump enough blood throughout the body. Heart failure does not mean that your heart has stopped or is about to stop working. It means that your heart is not able to pump blood the way that it should. The heart cannot fill with enough blood or pump with enough force or both. Go to the section on How the Heart Works for details. Heart failure develops over time as the pumping action of the heart grows weaker. It can affect the left side, the right side, or both sides of the heart. Most cases involve the left side where the heart cannot pump enough oxygen-rich blood to the rest of the body. With right-sided failure, the heart cannot effectively pump blood to the lungs where the blood picks up oxygen.
Q: What is heart valve disease?
A: Heart valve disease is when a valve in the heart is faulty. This can cause symptoms such as breathlessness and swollen ankles. Severe heart valve disease can result in permanent damage to the heart. Medicines can treat the symptoms, but some people will need surgery to repair or replace a faulty valve.
Q: What is high blood pressure and how is it treated?
A: Your heart pumps blood through a network of arteries, veins, and capillaries. The moving blood pushes against the arterial walls, and this force is measured as blood pressure. High blood pressure results from the tightening of very small arteries (arterioles) that regulate the blood flow through your body. As these arterioles tighten (or constrict), your heart has to work harder to pump blood through the smaller space and there is increased pressure inside the vessels. High blood pressure is so dangerous because it often has no symptoms. High blood pressure tends to run in families. Men are at higher risk than women, and blacks are at greater risk than whites. In most cases, high blood pressure can be controlled by eating a low-fat and/or low-salt diet; losing weight, if necessary; beginning a regular exercise program; learning to manage stress; quitting smoking; and drinking alcohol in moderation, if at all. Medicines, called antihypertensives, are available if these changes do not help control your blood pressure within 3 to 6 months.
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Q: What is insulin?
A: Insulin is a hormone. And like many hormones, it is a protein. Insulin is secreted by groups of cells within the pancreas called islet cells. Insulin is a necessary hormone. Those who develop a deficiency of insulin must have it replaced via shots or pumps (Type 1 Diabetes). More commonly, people will develop insulin resistance (Type 2 Diabetes) rather than a true deficiency of insulin. In this case, the levels of insulin in the blood are similar or even a little higher than in normal, non-diabetic individuals. Occasionally Type 2 diabetics will need insulin shots but most of the time other methods of treatment will work.
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Q: What is mitral valve prolapse?
A: The mitral valve regulates the flow of blood from the upper-left chamber (the left atrium) to the lower-left chamber (the left ventricle). Mitral valve prolapse (MVP) means that one or both of the valve flaps (called cusps or leaflets) are enlarged, and the flaps' supporting muscles are too long. Instead of closing evenly, one or both of the flaps collapse or bulge into the atrium. MVP is often called click-murmur syndrome because when the valve does not close properly, it makes a clicking sound and then a murmur. MVP is one of the most common forms of valve disease. It happens more often in women and tends to run in families. Most of the time, MVP is not a serious condition. Some patients say they feel palpitations (like their hearts skip a beat) or sharp chest pain. If you have MVP, you should talk to your doctor about taking antibiotic medicine before dental procedures or general surgery, especially if you have mitral regurgitation or thickened valve leaflets. This medicine will prevent infection of the valve.
Q: What is a MRI scan?
A: A MRI (magnetic resonance imaging) scan is an investigation that produces pictures of the inside of the body. Unlike an x-ray, however, an MRI scan does not use radiation to do this. Instead, a magnetic field is used to make the bodyís cells vibrate. They then give off electrical signals which are interpreted by a computer and turned into very detailed images of "slices" of the body. Having an MRI scan does not hurt. Different types of tissue show up in different colors on a computer-generated image, making it easy to identify any abnormalities. Depending on the part of the body that is being examined, it may be necessary to inject a contrast medium (dye) into the area, to make some of the tissues show up more clearly.
P
Q: What is a pacemaker and how does it work?
A: A pacemaker is a surgically implanted device that helps to regulate your heartbeat. Pacemakers use batteries to produce electrical impulses that make the heart pump. The impulses flow through tiny wires (called leads) that are attached to the heart. The impulses are timed to flow at regular intervals. Most pacemakers work only when they are needed. These are called demand pacemakers. They have a sensing device that either shuts off the pacemaker if the heartbeat is above a certain rate or turns the pacemaker on when the heart is beating too slowly. Pacemaker batteries can last up to five years or longer. Pacemakers and batteries can be replaced during a minor surgical procedure.
Q: What is Pericardial Effusion?
A: Pericardial effusion is a buildup of fluid in the space between the heart and the sac around the heart (pericardium). Inflammation of the pericardium (pericarditis) can lead to fluid buildup in the space surrounding the heart and can cause chest pain and, rarely, increased pressure on the heart (cardiac tamponade). Pericardial effusion can have many possible causes, including heart failure, tumors, lupus, bacterial or viral infection, or radiation treatment. Pericardial effusion may be drained in a procedure called pericardiocentesis, which involves using a needle and sometimes a thin tube called a catheter to drain the fluid. If the fluid buildup is gradual and the heart is tolerating the increased fluid around it, treatment of the underlying cause may be tried first.
Q: What is peripheral vascular disease (PVD)?
A: Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels - the arteries, veins, or lymphatic vessels. Organs supplied by these vessels such as the brain, heart, and legs, may not receive adequate blood flow for ordinary function. Conditions associated with PVD that affect the veins include deep vein thrombosis (DVT), varicose veins, and chronic venous insufficiency. When PVD occurs in the arteries outside the heart, it may be referred to as peripheral arterial disease (PAD). However, the terms "peripheral vascular disease" and "peripheral arterial disease" are often used interchangeably. In the US, 10 million people have peripheral artery disease. PAD occurs in 5 percent of adults older than 50 and in 20 percent of adults older than 70. It is frequently found in people with coronary artery disease, because atherosclerosis, which causes coronary artery disease, is a widespread disease of the arteries.
Q: What is pulmonary artery hypertension?
A: Pulmonary artery hypertension is when high blood pressure exists in the arteries that carry blood to the lungs. The extra blood being pumped to the lungs can increase the pressure in the pulmonary arteries. Over time, high pressure can damage the arteries and the small blood vessels in the lungs. They thicken and become stiff, making it harder for blood to flow through them (pulmonary vascular disease).
Q: What is pulmonary valve atresia?
A: Pulmonary valve atresia is a defect where a solid sheet of tissue forms instead of the pulmonary valve. This prevents oxygen-poor blood in the right side of the heart from traveling normally to the lungs to pick up oxygen.
Q: What is pulmonary valve stenosis?
A: Pulmonary valve stenosis is a narrowing of the pulmonary valve. This slows the flow of blood from the right side of the heart to the lungs. The heart must pump harder to push blood through the smaller opening to the lungs where the blood picks up oxygen.
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Q: What is restenosis?
A: Restenosis is the re-narrowing of a coronary artery. This re-narrowing occurs within three to six months in 40-50 percent of patients who have angioplasty. This incidence is reduced to approximately 20-30 percent with the use of traditional stent. Obviously restenosis remains a problem. Angioplasty (and stent placement in most situations) is a form of tissue trauma. Restenosis is the formation of new blockages at the site of the angioplasty and/or stent placement. There are two major mechanisms for restenosis. The first is by thrombosis, or blood clotting, at the site of treatment. The second form of restenosis is tissue growth at the site of treatment. Of course, recurrent atherosclerosis - the process that caused the coronary artery blockage in the first place - can also cause a recurrent blockage in a treated artery. But recurrent atherosclerosis accounts for very little restenosis during the first 6 months after angioplasty or stenting.
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Q: What is a stent?
A: A stent is a tiny mesh tube that looks like a small spring. The stent is inserted in the area where the artery is narrowed to keep it open. Some stents are "coated" with medication to help prevent the artery from closing again. Stents are used in most angioplasties except when an artery is too small for a stent to fit.
Q: What is a stroke?
A: A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain. The symptoms of a stroke include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause. There are two forms of stroke: ischemic - blockage of a blood vessel supplying the brain, and hemorrhagic - bleeding into or around the brain.
Q: What are stroke warning signs?
A: The warning signs for stroke may include a sudden, temporary weakness or numbness in your face or in your arm or leg; trouble talking or understanding others who are talking; temporary loss of eyesight, especially in one eye; double vision; unexplained headaches or a change in headache pattern; temporary dizziness or staggering when walking; or a transient ischemic attack (TIA).
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Q: What is a tricuspid atresia?
A: A tricuspid atresia is a defect where a solid sheet of tissue forms instead of the tricuspid valve. The tricuspid valve is between the right atrium (the upper chamber) and right ventricle (the lower chamber) of the heart. Without the tricuspid valve, oxygen-poor or blue blood entering the right atrium cannot travel normally to the lungs to pick up oxygen.
Q: What are triglycerides?
A: Triglycerides are fats that provide energy for your muscles. Like cholesterol, they are delivered to your body's cells by lipoproteins in the blood. If you eat foods with a lot of saturated fat or carbohydrates, you will raise your triglyceride levels. Elevated levels are thought to lead to a greater risk for heart disease, but scientists do not agree that high triglycerides alone are a risk factor for heart disease. Although triglycerides serve as a source of energy for your body, very high levels can lead to diabetes, pancreatitis, and chronic kidney disease. As triglyceride levels rise, HDL levels fall, which may help explain why people with high triglycerides appear to have an increased risk for heart disease.
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Q: What is ultrasound?
A: Ultrasound is a safe and painless method for examining the internal organs that avoids the use of X-rays. Instead, high-frequency sound waves are used and the echoes that result as the sound waves reflect off the soft tissue structures in the body form an image.
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Q: What are varicose veins?
A: Varicose veins affect up to 20% of men and 30% of women at sometime in their lives. They appear as swollen or twisted veins and are most commonly visible beneath the skin on the legs. For most people they are mainly a cosmetic problem. For others, they can cause a variety of symptoms and medical complications.
Q: What is Vasculitis?
A: Vasculitis is inflammation of blood vessels. In individuals with vasculitis, inflammation damages the lining of affected blood vessels, causing narrowing, the formation of blood clots (thrombosis), and/or blockage. As a result, there may be restriction of oxygenated blood supply to certain tissues (ischemia), potentially resulting in pain, tissue damage, and, in some cases, malfunction of certain affected organs. Vasculitis may affect veins and arteries of any type or size; may involve a single organ or many organs and tissues of the body; and may be a primary disease process or occur due to or in association with a number of different underlying disorders. Therefore, the range and severity of symptoms and findings associated with vasculitis may vary greatly. The specific underlying cause of vasculitis is not fully understood. However, in most cases, it is thought to be due to disturbances of the body's immune system.
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