Blood vessels, veins & amp; Veins

Circulatory disorders

Circulatory disorders


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Chronic circulatory disorders

Chronic circulatory disorders can occur if a vessel is narrowed or blocked. Older people in particular suffer from chronic circulatory disorders because the vessels lose elasticity with increasing age.

Unimpeded blood flow is important because the tissues and organs are supplied with oxygen and nutrients by the blood. If the blood flow is impeded, the tissue behind it is consequently no longer adequately supplied with oxygen. The condition of insufficient blood flow or complete loss of blood flow to tissues or organs is called ischemia. While the brain can only survive for a few minutes without oxygen, the kidneys and liver can survive for a few hours. The resting heart (e.g. artificially shut down during a heart operation) survives the lack of oxygen even over a period of several hours. Ischemia can, however, lead to cell death in the event of ongoing undersupply and, for example, cause a life-threatening heart attack or kidney infarction.

Definition

If the blood flow in one area of ​​the vascular system is restricted or blocked, the affected person suffers from circulatory disorders. These can be acute (sudden) or chronic (very slow). Circulatory disorders can occur anywhere in the body. Frequently, chronic circulatory disorders occur primarily in the legs, less frequently in the arms or organs. Men are affected more frequently than women.

Chronic circulatory disorders can have numerous causes. Progressive arteriosclerosis (“hardening of the arteries”) is often the cause of the symptoms. Vascular occlusion (embolism), vascular inflammation (vasculitis), formation of blood clots in the artery, low blood pressure (arterial hypotension) and vascular spasms (cramps in the muscles of the blood vessels) can also lead to circulatory disorders, among other causes.

Symptom of chronic circulatory disorders

If there are acute circulatory disorders, severe symptoms appear within a few minutes. If, for example, the extremities are affected by the undersupply, the lack of oxygen can lead, among other things, to pulse loss, pain, pallor, loss of sensitivity and numbness, paralysis and shock. Mostly, circulatory disorders develop slowly (chronically), so that there are no symptoms over a longer period of time. The complaints often only show up if there is already a serious illness.

The main cause of chronic circulatory disorders is the colloquial arteriosclerosis. This leads to deposits on the inside of the vessels, which transport the blood away from the heart (arteries). This gradually reduces the artery diameter until the affected area is completely blocked. It is believed that the smallest injuries on the inner wall of the vessel are responsible for the fact that the body's immune defense sets in and triggers complicated biochemical processes. As a result, blood cells, connective tissue, blood lipids and also lime are deposited as so-called plaques. The deposits usually occur at places in the vascular system where the uniform flow of blood is disturbed and where the vessels branch. Since the body is able to react to arteriosclerotic occlusions for a long time, the surrounding smaller blood vessels can initially take over the function of the narrowed artery and form so-called bypass circuits. Only when arteriosclerosis has progressed very far, do those affected develop symptoms that indicate chronic circulatory disorders.

Another common cause of circulatory disorders is embolism. Material that has been washed in with the blood usually clogs a narrow vessel. The “vascular plug” can consist of a blood clot (thrombosis), fat drops, air bubbles or parts of a tumor. The place of origin can be far from where the vessel is blocked.

Vascular inflammation is less often the cause of circulatory disorders. Then autoimmunological processes usually lead to symptoms in which the immune system is directed against your own body.

Circulatory disorders in the arms, legs and fingers

Peripheral arterial occlusive disease (PAD), sometimes also called chronic arterial occlusive disease (AVK), includes a clinical picture in which sufferers suffer from chronic circulatory disorders in the extremities. The legs are often affected. The symptoms, which depend on the stage of the disease, include severe pain, so that those affected often have to stop after a few meters before they can continue. Colloquially, the disease is therefore also referred to as "window disease", because the frequent breaks in walking give the impression of window shopping.

The cause of PAD is a stenosis (narrowing) or occlusion (occlusion) of the arteries responsible for the supply of the extremities. The main artery can also be affected, albeit rarely. PAD usually precedes arteriosclerosis, the symptoms of which range from freedom from complaints and slight difficulty walking to tissue necrosis requiring amputation.

While those affected initially have no complaints due to the changes in the vessels, these occur later in the course of the disease, especially under stress, such as walking, and subside again at rest. If the occlusive disease progresses, the sometimes severe pain is also noticeable when at rest, when lying down and when the legs are raised. Many sufferers have less gravity-related discomfort while sitting due to the improved blood circulation. In the last stage of the disease, tissue damage already occurs, which can lead to the so-called smoker's leg, for example.

Another clinical picture that is associated with circulatory disorders is Raynaud's syndrome (Raynaud's disease). The vessels of the fingers or toes cramp due to external influences such as cold or stress. At first the affected areas appear white, then bluish and finally reddish when they are supplied with blood again. The mostly female sufferers rarely complain of pain. Circulatory disorders of the fingers can, however, also indicate other diseases such as autoimmune diseases in which the immune system attacks the body's own tissue.

Circulatory disorders in the organs

The organs can also be affected by chronic circulatory disorders. If the heart muscle is no longer adequately supplied with blood due to constricted coronary arteries (coronary arteries), there is coronary heart disease. Due to the resulting lack of oxygen, sufferers also experience the feeling of “chest tightness” and chest pain (angina pectoris). Usually the pain disappears after a few minutes either on its own or after taking a nitro preparation. However, if the pain persists, it can be an indication of a heart attack. Coronary artery disease is the number one cause of death in industrialized countries. If a suspected poor circulation of the heart muscle or corresponding symptoms are suspected, a doctor should be consulted immediately.

The arteries of the intestine can also be narrowed or closed, so that chronic circulatory disorders can develop in the context of visceral artery insufficiency. People often complain of abdominal pain after eating. In addition, the symptoms lead to anorexia, so that patients lose weight quickly (angina intestinalis). More rarely, an acute occlusion can be caused by a blood clot that is life-threatening. In addition to construction pain, nausea and vomiting as well as the first signs of shock usually occur. In the further course the symptoms often improve, however the general condition of the patient worsens until eventually intestinal paralysis and peritonitis develop. The intestinal tissue dies.

Risk factors

Risk factors for circulatory disorders include high blood pressure, obesity, diabetes mellitus (diabetes), fat metabolism disorders or increased blood lipid levels, smoking and lack of exercise. If there is no underlying disease, circulatory disorders are mostly due to an unhealthy lifestyle. It is therefore not surprising that circulatory disorders are widespread, especially in industrialized countries, where both a high-fat diet and nicotine consumption are commonplace. If there is also a lack of sporting activities, many suffer from the common disease.

In order to prevent circulatory disorders, doctors recommend giving up nicotine and getting enough exercise. A balanced, healthy diet, such as the Mediterranean diet, is also recommended. Foods that promote blood circulation include garlic, ginger, pomegranate and high-fat fish such as salmon and mackerel.

Diagnosis

An initial, preliminary diagnosis of chronic circulatory disorders is often possible as early as the first examination, since typical symptoms usually appear. The doctor first asks questions about the medical history and the occurrence of the symptoms. Subsequently, various examinations to make a differentiated diagnosis come into question. A blood pressure measurement on both arms can indicate a change in the blood vessel should the values ​​differ significantly. Furthermore, so-called provocation tests can be carried out, in which the doctor uses movement tests to test whether the circulatory disorders can be caused by certain movements or loads. In this way, statements about the severity can be made, for example.

With Doppler sonography, which is also used for circulatory disorders in the extremities, the systolic blood pressure is measured on both ankles and upper arms after the patient has rested for 15 minutes. The doctor can use the so-called ankle-arm index (Doppler index) to determine whether there is a circulatory disorder. In a similar way, oscillography using pulse-volume curves is used for diagnosis.

If it is already certain that the treatment of the circulatory disorders is carried out by a surgical intervention, angiography can be carried out, in which the affected arteries can be examined more closely. However, the examination can have side effects such as subsequent bleeding. Further investigations may also be necessary.

Treatment options

In principle, circulatory disorders should be examined by a doctor. In the event of acute vascular occlusion, immediate action must be taken, since the life of the patient can be threatened, such as a heart attack.

In the case of circulatory disorders, the therapy is usually carried out with medication, depending on the cause. So-called platelet aggregation inhibitors improve the flow properties of the blood. Blood circulation can also be supported with prostaglandins, which have a vasodilating effect. Medications can also be used to dissolve relatively fresh clots. Last but not least, pain relievers may also be necessary for people with poor circulation.

In some cases, surgery is inevitable, for example if parts of the intestine have already died when the intestinal arteries are closed. One of the easier procedures that are usually performed under local anesthesia is the surgical removal of a blood professor. It may also be necessary to remove the deposits from a blocked vessel or to perform a “bypass” in an operation. If the arms and legs have poor circulation, the amputation may be necessary, for example in the case of a smoker's leg.

Naturopathy for circulatory disorders

Frequently, circulatory disorders can also be treated with measures to stimulate the circulation. Movement therapy and Kneipp treatments, which are often very effective, come into question here. Acupuncture may be suitable for pain relief. In the area of ​​Kneipp hydrotherapy, for example, the alternating arm bath has proven itself. For this you need two large bowls or tubs (or a two-part sink), which you fill once with at least 36 degrees warm water and below 18 degrees cold water. Now sit down and hold your arms in the warm pool for five minutes, then in the cold pool for ten seconds. Then repeat the process once. After use, the arms are stripped and gently moved to warm them up again.

In the initial phase of circulatory disorders, homeopathy can be promising. Depending on the complaints, Abrotanum, (boar rose), Tabacum (tobacco), Espeletia grandiflora, Secale cornutum (ergot) and Creosotum (beechwood tar) are used. Herbal medicines with horse chestnut extracts can also be very helpful for problems with blood circulation. (ag)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr Astrid Goldmayer, Barbara Schindewolf-Lensch

Swell:

  • Erwin German; Herbert Ehringer: Circulatory disorders, measurement methodology and pharmacotherapy (Raubasin): international symposium December 5 to 7, 1968, Schattauer, 1970
  • Bernd L. P. Luther: Intestinal circulatory disorders, Steinkopff Verlag, 2001
  • P. Gerhardt Scheurlen: Differential Diagnosis in Internal Medicine, Springer-Verlag, 2013
  • Cem cetin; Iris Baumgartner: "The peripheral arterial occlusive disease", in: Swiss Medical Forum, Volume 4, 2004, medicalforum.ch
  • Pschyrembel Online: www.pschyrembel.de (access: August 20, 2019), circulatory disorder
  • K. Witte; C. Haller: "Atherosclerosis and circulatory disorders", in: Pharmacotherapy, Springer, 2004, Springer Link


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