Patients with chronic post-prandial epigastric pain may have median arcuate ligament syndrome (MALS). The median arcuate ligament is a part of the diaphragm that surrounds the aorta. The diaphragm moves with respiration. In theory, this movement may cause tension on the celiac artery or on the nerves surrounding the celiac plexus. But there is much…
Segmental arterial mediolysis is a disorder of arteries. It is non-atherosclerotic and non-inflammatory. It occurs most commonly in the visceral arteries. Having said that, it has been described in other arteries such as cerebral arteries and coronary arteries. This condition affects mainly middle-aged men, however it has been described in neonates and children. Presentation and…
Leg cramps at night are painful and troublesome. But they are very common. They are the most common way people experience night leg pain. A leg cramp feels like a “Charlie-horse” or being “smacked” right to the muscle. In some people leg cramps at night are so frequent that they interfere with sleep. Leg cramps…
Acrocyanosis means “blue extremities”. In practice it usually means purple feet, but it can involve the hands. Acrocyanosis is part of the differential diagnosis for blue fingers and blue toes. Of course, there are many reasons for blue extremities. However, when we use the term acrocyanosis we mean it in a particular way. What are…
Leg pain when walking is common. The most common vascular reason is peripheral artery disease (PAD). This leg pain is called intermittent claudication. But, many causes of leg pain when walking are not vascular. Figuring out the cause is not always simple. 6 Causes for Leg Pain when Walking that are NOT vascular Leg pain…
Livedoid vasculopathy is a type of skin vasculitis. It is often chronic, remitting. The main component are painful skin lesions. It is most often on the feet and lower extremities. It usually does not involve other organs. The mechanism is secondary to local thrombosis. Clinical Manifestations The lesions develop in stages. There is an inflammatory…
Digital ulcers may develop in scleroderma patients. Most systemic sclerosis patients will have digital ulcers at some point. In some, ulcers are persistent. Sometimes they progress to gangrene and amputation. These scleroderma ulcers are difficult to treat because of vascular disease in scleroderma. In general, the treatment of scleroderma ulcers should be multi-faceted. It should…
Buerger’s disease is also called thromboangiitis obliterans. It is associated with smoking and affects the arteries, veins and nerves. The only real treatment is smoking cessation. Avoiding chewing tobacco and marijuana is also critical. What causes Buerger’s disease? Buerger’s disease is typically a disease of young men. If a patient is older than 45 years,…
Vascular Ehlers-Danlos Syndrome is part of a group of conditions. Most types of Ehlers Danlos do not affect the arteries. However, they all involve connective tissue. For this reason, Vascular Ehlers-Danlos involves more than the arteries. It can manifest in the skin, joint capsules, hollow organs (such as the uterus) and the gastrointestinal tract. Vascular…
Intermittent claudication means there is leg pain when walking. We can measure the blood flow to the legs with simple blood pressure cuffs. The ratio of blood reaching the legs to the blood reaching the arms is called the ankle brachial index or ABI. The lower the ABI, the worse the blood flow is. As…
