Angiology Topic Homepage
Angiology Overview
Angiology is the medical specialty that involves pathology and treatment of vessels whatever their nature; blood (veins, arteries, capillaries) or lymphatic vessels.
Cardiovascular diseases remain the major cause of death across Europe, and are a major cause of morbidity and loss of quality of life.1 Each year, more than 4 million Europeans die of cardiovascular disease.1 The large majority of these...
... cardiovascular events are due to atherosclerosis.1
Atherosclerosis is characterised by the deposit of a lipid plaque (atheroma) on the artery walls, causing damage (sclerosis).2 The progressive obstruction of vessels primarily affects the coronary arteries; atherosclerosis accounts for the vast majority of cases of myocardial infarction and angina pectoris, but is also the cause of stroke.2
Several risk factors are involved in atherosclerosis; hypercholesterolemia, hypertension, smoking, stress, physical inactivity, obesity and diabetes.1 Diabetes is a major risk factor, with 80% of all deaths in diabetic patients being attributed to atherosclerosis.3
Varicose veins and chronic venous insufficiency are also very common in developed countries with an incidence of between 25% and 33%, depending on the country, and more often affecting women than men.4 Chronic venous insufficiency can cause serious diseases such as ulcer, phlebitis (thrombophlebitis) or pulmonary embolism, if the clot reaches the pulmonary artery.5
Angiosarcoma is a rare cancer that develops from cells of the inner lining of the walls of blood and lymph vessels (endothelium).6 This is high-grade malignant tumor, accounting for less than 2% of the soft tissue sarcomas, and is due to exposure to toxic metals.6
Efforts have been made in the prevention of risk factors, and the therapeutic management of stroke, by many European states. These must be pursued further in order to reduce morbidity and mortality.1
1. Scholte op Reimer W. et al. Euro Cardiovascular diseases in Europe 2006. Heart Survey. European Society of Cardiology. 2006 : available online.
2. Mizuno Y. et al. Inflammation and the development of atherosclerosis. Journal of Atherosclerosis and Thrombosis. May 2011 ; 18 (5) : 351-8.
3. Bansilal S. et al. Optimal treatment of the diabetic patient with multivessel disease. Current Cardiology Reports. 2008 ; 10 (4) : 272-284.
4. Meissner M.H et al. Pathophysiology of Varicose Veins and Chronic Venous Insufficiency. Comprehensive Vascular and Endovascular Surgery. Second Edition. 2009 : 729-748.
5. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003 : 231-239.
6. Papadimitriou V.D. et al. Angiosarcoma of kidney: a case report and review of literature. Urology Journal. Summer 2009 ; 6 (3) : 223-5.
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Heart Failure
Heart Failure is a progressive chronic disorder that results in the inability of the heart to pump blood efficiently to the body’s tissues.
Chronic heart failure is an increasing public health problem; the growing prevalence in industrialised countries means that 1-2% of the adult population of these countries are now thought to have chronic heart failure.1-3 Estimates suggest that the prevalence in Europe, USA and Japan could increase by approximately 16.5% over the next ten years.4
The prevalence of post-myocardial infarction heart failure is less well known as it is difficult to distinguish between pre-existing and incident heart failure. However current estimates suggest that approximately 1 in 5 patients hospitalised with an acute coronary syndrome either present with heart failure or develop heart failure during their hospital stay.5
Many of the signs and symptoms of heart failure are non-specific and vary in severity depending on the disease class. The most common of these are breathlessness, fatigue, exercise intolerance, and fluid retention as evidenced by ankle swelling, peripheral oedema, and an elevated jugular venous pressure.6
Due to the non-specific nature of symptoms, the diagnosis of heart failure can be difficult. Tests can include echocardiogram, ECG, chest X-ray, laboratory tests. Following a positive diagnosis heart failure is classified into functional classes that relate to disease severity.
Management of heart failure involves lifestyle modifications, pharmacological treatment and occasionally surgery. In patients with chronic heart failure, optimal therapy involves treatment with diuretics, ACE inhibitors, certain β-blockers and a mineralocorticoid receptor antagonist.
The Heart Failure Knowledge Centre brings together current information related to chronic heart failure and post-myocardial infarction, including:
- Epidemiology
- Symptoms and Diagnosis
- Classification
- Treatment Options
References
- Zannad F, et al. Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL Study. Journal of the American College of Cardiology 1999; 33(3):734-742.
- Cowie MR, et al. The epidemiology of heart failure. European Heart Journal 1997;18(2):208-225.
- Mosterd A, Hoes A. Clinical epidemiology of heart failure. Heart 2007; 93:1137-1146.
- Decision Resources. Chronic Heart Failure. Cardium Study No.4 A Pharmacor Service. 2008.
- Steg PG, Dabbous OH, et al. Determinants and prognostic impact of heart failure complicating acutecoronary syndromes. Observations from the Global Registry of Acute Coronary Events (GRACE). Circulation2004;109:494-9.
- NICE Clinical Guideline No 108. Chronic Heart Failure. National clinical guideline for diagnosis and management in primary and secondary care. 2010.
Clinical Case Studies
Leptospirosis
Infection: Community-acquired Bloodstream InfectionsEmma Louise Hathorn, Specialist Registrar in Genitourinary Medicine, Whittall Street Clinic, Heart of Birmingham Teaching NHS Primary Care Trust, Birmingham, UK
Case History
A 28-year-old man presented complaining of headache, myalgia, anorexia, fever and sweats. His symptoms had started approximately seven days after he had chased his dog into a marsh from which he had to be rescued.
Meningococcal Meningitis
Infection: Community-acquired Bloodstream InfectionsChristopher Duncan, Research Fellow, Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
Case History
A 36-year-old woman was admitted with sudden-onset severe occipital headache, photophobia and vomiting. On physical examination she was afebrile, with obvious photophobia and neck stiffness but no skin rashes.
Drug News
Genous stent (Orbus Neich) has lower restenosis rate than bare metal stents in ACS treatment
22-05-2013
OrbusNeich announced that the company's Genous Stent is associated with a significantly lower rate of binary restenosis compared to bare metal stents (BMS) in low-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients at six months.
Data from JACK-EPC, an investigator-initiated randomized study, were published in the June issue of Minerva CardioangiologicaStent, of...
Xience Xpedition 48 everolimus eluting coronary stent from Abbott Vascular has CE Mark
22-05-2013Abbott announced CE Mark granted on 21 May 2013 in Europe for the Xience Xpedition 48 Everolimus Eluting Coronary Stent System, the first-of-its-kind treatment for very long blockages in the vessels that supply blood to the heart due to coronary artery disease (CAD). Xience Xpedition 48 leverages the proven design and clinical outcomes of the Xience family of drug eluting stents in a unique 48...
Results from registry study of Symplicity (Medtronic) confirm safety profile
22-05-2013The first results from the Global SYMPLICITY Registry reaffirmed the safety of the Symplicity renal denervation system, from Medtronic, in a real-world patient population. Among the 617 registry patients with follow-up information available for this first analysis, no major complications or serious adverse events related to delivery of radio frequency energy to the renal artery were reported....
Angiology Drug Data - A-Z
Possible searches include drugs or medicines (by brand, generic ingredient or drug class), diseases, conditions and more.
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Recent Drug Updates
Omacor
22-05-2013Post Myocardial Infarction Adjuvant treatment in secondary prevention after myocardial infarction, in addition to other standard therapy (e.g. statins, anti-platelet medicinal products, ...
Aprovel Film-Coated Tablets (sanofi-aventis Bristol-Myers Squibb SNC)
14-05-2013Aprovel is indicated in adults for the treatment of essential hypertension. It is also indicated for the treatment of renal disease in adult patients with hypertension and type 2 diabetes mellitus...
Ranexa prolonged-release tablets
08-05-2013Ranexa is indicated in adults as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled or intolerant to first-line antianginal...
Clinical Guidelines
Ivabradine for treating chronic heart failure
Nov 2012Ivabradine (Procoralan, Servier Laboratories) is a heart-rate-lowering agent that selectively and..
... specifically inhibits the cardiac pacemaker If current, which controls the spontaneous diastolic depolarisation in the sinus node that regulates the heart rate.
Alteplase for treating acute ischaemic stroke
Sep 2012Alteplase (Actilyse, Boehringer Ingelheim) is a tissue plasminogen activator manufactured by..
... recombinant DNA technology. It activates the production of plasmin from its precursor plasminogen. Plasmin is an enzyme that degrades fibrin clots. The aim of treatment is to reduce the impact of ischaemia by restoring blood flow through the occluded (blocked) artery.
Online CME
Opioids for Refractory Dyspnea
Apr 2013
... for relieving refractory dyspnea, based on a review.
Clinical Trials
Non-invasive Diagnostics of Pulmonary Hypertension With Dual Energy Computed Tomography
09-04-2013The aim of the study is to determine relevant hemodynamic parameters for the diagnostics of pulmonary arterial hypertension (PAH) by dynamic contrast enhanced dual-energy CT (DE-CT). In this prospective study the investigators validate DE-CT results of patients against hemodynamic parameters from right heart..
... catheterisation and control the results by other clinical investigations. The investigators expect that using this non-invasive method, parameters relevant for the diagnosis of the patients with PAH, like pulmonary blood volume, blood flow and perfusion heterogeneity, can be determined.
Comparison of Low and Intermediate Dose Low-molecular-weight Heparin to Prevent Recurrent Venous Thromboembolism in Pregnancy
05-04-2013This is a randomized-controlled open-label trial comparing two different doses of low-molecular-weight heparin (LMWH) in pregnant patients with a history of previous venous thromboembolism (VTE). Both doses are recommended doses in the 2012 guidelines of the American College of Chest Physicians (ACCP), but it is not..
... known which dose is more efficacious in preventing recurrent venous thromboembolism in pregnancy.
Medical Videos
Medical Journal Abstracts
Local Versus Epidural Anesthesia in Fast-Track Abdominal Aortic Surgery
Journal of Cardiothoracic and Vascular Anesthesia
Jan 2013
Objective: The aim of this study was to investigate a possible alternative to epidural anesthesia/analgesia. The authors compared thoracic epidural anesthesia/analgesia with continuous wound infiltration anesthesia/analgesia in patients scheduled for mini-invasive abdominal aortic surgery in a fast-track setting...
β-Blockers and Volatile Anesthetics May Attenuate Cardioprotection by Remote Preconditioning in Adult Cardiac Surgery: A Meta-analysis of 15 Randomized Trials
Journal of Cardiothoracic and Vascular Anesthesia
Jan 2013
Objective: Clinical trials on cardioprotection by remote ischemic preconditioning (RIPC) for adult patients undergoing cardiac surgery revealed mixed results. Previous meta-analyses have been conducted and found marked heterogeneity among studies. The aim of this meta-analysis was to evaluate the factors affecting..
Medical Apps
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Social Media
ECG Quiz
on doc2docECG Quiz posterior wall MI with reciprocal changes in lateral leads, absence of 'p' wave, missed beats (conduction abnormality) act as corobarative ...
Frailty. Is it an important clinical syndrome?
on doc2doc... certain diseases like malignancies, cardiovascular disorders or stroke, rather than a separate syndrome. Management of frail patients requires ...
Learning Bite
on doc2doc... Wellens and colleagues in 1982 in a subgroup of patients with unstable angina,[2] it does not seem to be rare, appearing in 18% of patients in his ...
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