Buerger disease (Circulatory System and Disease) Video Lecture - MBBS

Voiceover: What would
happen if you narrow the
blood vessels in your
fingers and in your hand?
What would you see? What would happen?
Well, of course we'd see
decreased blood flow,
which means decreased oxygen
delivery to the tissues, right.
Decreased oxygen delivery to your fingers,
which can lead to pain.
It's very similar to what
happens in the heart.
If you have decreased
blood flow to the heart,
then you can feel anginal pain, right.
Angina, chest pain.
Here, it's very similar,
you get a muscular pain,
which is known as claudications.
Now, what happens if the blockage is
so severe that you have complete blockage?
It's no longer narrowed, it's
just completely blocked off.
Well, you're not going to get any more
blood to your fingers, and so it makes
sense, they're going to die.
The cells in them are going to die,
and your fingers will fall off.
This is called autoamputation.
These are two of the main symptoms found
in the vasculitis called
Buerger's disease.
Recently, there's been a movement in
Medicine in trying to rename diseases
that are named after guys like Buerger.
And they're trying to make it easier
for people like us to
understand medical terminology,
and so they've tried to
rename some diseases.
In this case, they've renamed this
thromboangiitis obliterans,
so much for really
help us understand what it means, right.
Let's break it down.
It may be a mouthful, but when we take
a look at it, actually
makes a lot of sense.
Thrombo means clotting right.
Angitis is inflammation of blood vessels,
which is really the root of vasculitis.
Remember vasculitis is
vessel inflammation.
Angitis is just another name for this.
And lastly, obliterans, which is a term
for artery occlusion or artery blockage.
Obliterans pretty much
just means blockage.
So, here we've got clot formation,
vessel inflammation, and blockage.
We can think there is
vessel inflammations,
disease causing a clot, which
creates a blockage in blood flow.
And so you see these symptoms of
claudication, autoamputation,
death of the cells,
necrotizing vasculitis.
Other symptoms that you see
are ischemic ulcers, gangrene.
These are all terms for the same thing.
Ischemic ulcer: Blood flow, blood decrease
causing skin damage.
Gangrene: Cell death of fingers and toes,
damaged dead cells.
This is not just the
hands, actually the feet
are involved as well.
Most common symptom is
forefoot pain, pain right here.
Now, this can be diagnosed
with an ultrasound.
Taking a look with a probe and seeing
what it displays on the screen.
And here, we'll see
narrowing of blood vessels.
Not only that, you can
also use an angiography.
Angiography is a way to visualize
the inside of blood vessels.
What you do is you have
a patient take this fluid
called contrast that has a
high radiological isotope.
Basically, it can be seen when you use
something like an x-ray or
a scan, a radiological scan.
And so it gets absorbed into your
blood stream and allows
physicians to visualize
how the blood vessels look on the inside.
So if there is a blockage in the artery,
the physician will see this narrowing
because there is less
blood flow through an area.
Another thing you can see in
angiography is some spiraling.
A cork screwing pattern of
arteries around a blockage,
so arteries create this
cork screwing because they
go through a pattern of
growth, damage, regrowth.
They're trying to create
a new fresh artery.
A risk factor of this disease is smoking.
The pathophysiology
isn't quite understood,
but it's believed that
something in the tobacco
or something in the cigarette is causing
the immune system to respond.
And for some reason, vessels in your
hands and your feet are affected.
The only definitive
treatment is to stop smoking.
There is no medication that really can be
given to stop the
progress of this disease.
So patients are urged to really quit.
Otherwise, they may lose
their fingers or toes.
If that's not enough motivation, then
I don't know what else would be.