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The different types of shock are characterized by the same clinical signs.

A. Hypotension
Hypotension in adults is traditionally defined as a systolic blood pressure of 90 mm…

Introduction

Essentials of Diagnosis

• Painless edema of upper or lower extremities.
• Involves the dorsal surfaces of the hands and fingers or the feet and toes.
• Developmental or acquired, unilateral or bilateral.…

Introduction

Superior vena cava syndrome is a rare disorder caused by partial or complete obstruction of the superior vena cava. The most frequent causes are (1) superior mediastinal tumors (responsible for over…

Introduction

Essentials of Diagnosis

• Red streak extending from an infected area toward enlarged, tender regional lymph nodes.
• Chills, fever, and malaise may be present.

General Considerations

Lymphangitis and…

Introduction

Essentials of Diagnosis

• History of phlebitis or leg injury.
• Ankle edema is the earliest sign.
• Late signs are stasis pigmentation, dermatitis, subcutaneous induration, varicosities, and ulceration.

Introduction

Essentials of Diagnosis

• Pain in the calf or thigh, often associated with edema. Fifty percent of patients are asymptomatic.
• History of congestive heart failure, recent surgery,…

Introduction

Essentials of Diagnosis

• Induration, redness, and tenderness along a superficial vein.
• Often a history of recent intravenous line or trauma. No significant swelling of the extremity.…

Thoracic outlet syndrome can be subdivided into neurogenic, venous, and arterial types depending on which structures are compressed in the interscalene triangle or costoclavicular space.

Neurogenic thoracic outlet syndrome is the most common…

Introduction

Essentials of Diagnosis

• Dilated, tortuous superficial veins in the lower extremities.
• May be asymptomatic or associated with fatigue, aching discomfort, bleeding, or localized pain.
• Edema, pigmentation, and ulceration…

Introduction

Essentials of Diagnosis

• Burning or aching pain of greater severity and longer duration than expected following trauma to an extremity.
• Manifestations of…

Erythromelalgia is a paroxysmal bilateral vasodilatory disorder of unknown cause. Idiopathic (primary) erythromelalgia occurs in otherwise healthy persons and affects men and women equally. A secondary type is occasionally seen in patients with polycythemia vera, hypertension,…

Acrocyanosis is an uncommon vasospastic disorder characterized by persistent cyanosis of the hands and feet and, to a lesser degree, the forearms and legs. It is associated with arteriolar vasoconstriction combined with dilation of the subcapillary…

Livedo reticularis is a vasospastic disorder of unknown cause that results in a painless, mottled discoloration on large areas of the extremities, generally in a fishnet pattern with reticulated cyanotic areas surrounding a paler central…

Introduction

Essentials of Diagnosis

• Episodic bilateral digital pallor, cyanosis, and rubor.
• Precipitated by cold or emotional stress; relieved by warmth.
• Seventy to 80 percent of patients are…

Fibromuscular Dysplasia
Fibromuscular dysplasia is a nonatherosclerotic, noninflammatory disease of unknown cause characterized by segmental irregularity of small and medium-sized muscular arteries. Typically, it affects white women 30-50 years of age; a family history…

Renal artery stenosis is produced predominantly by atherosclerotic occlusive disease (80-90% of patients) or fibromuscular dysplasia (10-15% of patients). Characteristically, patients with occlusive disease have common risk factors for atherosclerosis, and their lesions are…

Chronic intestinal ischemia results from atherosclerotic occlusive lesions at the origins of the superior mesenteric artery (SMA), celiac artery, and inferior mesenteric artery (IMA). Because of collateral flow via the middle colic artery branch…

Carotid Dissection
Carotid dissection is a false channel in the wall of the carotid artery produced by a tear in the intima. The classic triad of symptoms is unilateral…

The most common cause of popliteal artery occlusion is athero-occlusive disease. Thrombosis of a popliteal aneurysm can also cause popliteal occlusion and acute leg ischemia. Claudication in a young, athletic individual…