In a few large and infinitely small arteries and veins, the blood flows through our body - a total of six liters of blood are thus constantly moved by the heart. But cardiovascular diseases are the most common cause of death in Germany - because arteriosclerosis and high blood pressure put the vessels to.
Layout and function
The heart pumps the oxygen-enriched blood into the most distant parts of the body with vigorous pressure. The blood flows through the aorta into other large arteries, which divide into smaller and smallest arteries. These smallest arteries eventually end up in the organs where the blood components do their job: supplying the cells with oxygen and nutrients or warding off pathogens.
The return of the blood to the heart happens in other vessels, the veins. While arteries have a relatively thick, elastic wall because of the high blood pressure, veins are only covered by a thin wall and have door-like flaps. The blood is pushed in the veins towards the heart by the movement of the muscles that are in the vicinity - the reflux is prevented by the valves. In people who move little, the blood flows slowly from the legs back into the heart - so easily develop varicose veins.
Blood is the most important body fluid, but there is also the lymphatic fluid, which flows in the finest lymph channels through the tissue and transport breakdown products of the metabolism and defense cells. The importance of this lesser-known fluid transport is usually noticed only in the case of disease - as in lymphedema or elephantiasis.
Complaints to the vessels
In the arteries, a narrowing to complete occlusion or bleeding may occur. Narrowed vessels mean circulatory disorder (ischemia) with less oxygen and nutrients for the organs - pain, paleness and weakness are the consequences. Heart disease causes CHD, stroke in the brain and arterial occlusive disease on the legs.
Typical vein complaints are fat legs after standing for a long time or spider veins and varicose veins. If the blood flow becomes too slow, clots can form - causing a thrombosis. Thromboses are also venous diseases, but rarely occur in a calcified and narrowed artery.
In addition, deviations in blood pressure from the normal range lead to complaints: too low blood pressure can cause dizziness or a circulatory collapse, high blood pressure, palpitations, sweating or even nosebleeds - and is long-term breeding ground for stroke, heart failure and kidney failure.
Anamnesis (ask the medical history): All complaints can be further limited by specific questions. Pain in the legs can occur after a short distance or only after a long walk. The beginning and localization of the pain (whether in the lower leg or thigh) indicate the height at which the arteries are blocked.
Inspection and auscultation: A visible sign of ischemia in the legs is pallor. Narrowed neck arteries sometimes make a whirring noise - and an aneurysm of the abdominal aorta can be gently palpated.
Blood pressure measurement: The method is standard in every examination - but correct blood pressure measurement is not that easy!
Blood and urine tests: Risk factors such as high blood sugar, high blood lipids or cholesterol levels are determined and then controlled after taking medication. Protein in the urine indicates how severely the high blood pressure has damaged the kidney.
X-ray and ultrasound: In the X-ray you can see vessels well when filled with contrast medium. This examination is available for arteries (angiography) and for veins (venography). Modern ultrasound devices are able to accurately represent the blood flow in the vessels and deposits on the vessel walls such as lime or blood clots.
Computed Tomography and Magnetic Resonance Imaging: are used in a stroke or arterial tear, for example, to detect spread.
Consequences of an arterial narrowing
Too high blood pressure or an unhealthy change in the blood components with too much blood sugar, high blood lipids and cholesterol or too little homocysteine lead in the long term to arteriosclerosis - which is usually the reason for an arterial narrowing. But even a blood clot can block the bloodstream. Narrowed arteries lead to oxygen depletion (ischemia) and in the worst case death (infarction) of organs. Thus, ischemia of the legs in the intercostal disease, ischemia of the heart (CHD) in an anginal attack.
A particular problem is stroke, which is triggered by ischemia in the brain. This is usually an arterial occlusion responsible, less often a cerebral hemorrhage. A stroke may be characterized by tingling or numbness in the arms or legs, followed by paralysis, speech and visual difficulties.
Too low a blood pressure is annoying - but too high a blood pressure leads in the long run to a massive impairment of the vessels and has serious consequences such as heart failure, hypertonic retinopathy or a chronic kidney failure. An important risk factor for high blood pressure and atherosclerosis is diabetes mellitus dar. Already during the precursor insulin resistance, the vessels are damaged by the high blood sugar.
In addition, the risk factor overweight - if the fat is distributed dangerously - plays an important role in the vascular damage. An aortic aneurysm usually occurs when the wall of the aorta has been so damaged by calcification that it can form an outgrowth.
Diseases of the veins
Venous diseases range from cosmetically unsightly spider veins to an open leg - depending on how severely the veins and venous valves are damaged. If the drainage of the lymphatics is disturbed - in case of injury, irradiation (eg as part of a cancer treatment) or by pressure on the lymphatics (eg through tight clothing or a tumor) - the affected body part, the lymphedema, swells.
Since vascular disease often occurs with the "deadly quartet", reducing overweight, drug treatment of a lipid metabolism disorder with a statin, treatment of high blood pressure, diabetes or insulin resistance are the first therapeutic measures.
Treatment of vascular disease
Common drugs include beta-blockers to normalize blood pressure and acetylsalicylic acid to lower the risk of heart attack and "dilute" the blood. When taking the tablets, the correct time of administration must be observed, otherwise the medication will not work. Congested arteries on the neck, arms and legs can often be minimally invasively stretched with a catheter - similar to that which is usual at the heart with a cardiac catheter and as well as heart operations are now carried out minimally invasively. If the blood circulation can not be restored, the body part dies - it must be amputated. This often causes phantom pain on legs and arms.
After a stroke, optimal care in a stroke unit is particularly important to keep brain damage as low as possible. Ultrasound seems to be a promising new treatment method. Venous diseases are treated with various types of surgery - sclerotherapy, laser therapy and radio waves are just a few of many. Of course, there is a special procedure for each disease with medication or surgery - you can find more information on the particular disease.
To prevent atherosclerosis and high blood pressure, it is best to take good care of adolescents as a healthy diet, a conscious use of cholesterol, a lot of exercise and stress relief. Here, Mediterranean fare with olive oil, onions and garlic and red wine (properly dosed) is particularly recommended.
Especially with high blood pressure, the lifestyle is crucial: quitting smoking and a sensitive approach to salt and foods such as licorice should be self-evident. It is also important to carry out the regular health checks and to seek medical attention in case of suspected heart disease.
In the summer, cardiovascular patients should pay particular attention to themselves - and did you know that the flu shot apparently lowers the risk of heart attack? When you fly, think about the risk of thrombosis and help your body with exercise and lots of fluids. Tired or sick veins can be treated well with fitness - even compression stockings and horse chestnut or vine leaf extracts work wonders.