Your vascular system is your body's network of blood vessels. It includes your

• Arteries, which carry oxygen-rich blood from your heart to your tissues and organs
• Veins, which carry the blood and waste products back to your heart
• Capillaries, which are tiny blood vessels that connect your small arteries to your small veins. The walls of the capillaries are thin and leaky, to allow for an exchange of materials between your tissues and blood.

Vascular diseases are conditions which affect your vascular system. They are common and can be serious. Some types include

• Aneurysm - a bulge or "ballooning" in the wall of an artery
• Atherosclerosis - a disease in which plaque builds up inside your arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.
• Blood clots, including deep vein thrombosis and pulmonary embolism
• Coronary artery disease and carotid artery disease, diseases that involve the narrowing or blockage of an artery. The cause is usually a buildup of plaque.
• Raynaud's disease - a disorder that causes the blood vessels to narrow when you are cold or feeling stressed
• Stroke - a serious condition that happens when blood flow to your brain stops.
• Varicose veins - swollen, twisted veins that you can see just under the skin
• Vasculitis - inflammation of the blood vessels

An aneurysm is a bulge or "ballooning" in the wall of an artery. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of the body. If an aneurysm grows large, it can burst and cause dangerous bleeding or even death.

Most aneurysms occur in the aorta, the main artery that runs from the heart through the chest and abdomen. Aneurysms also can happen in arteries in the brain, heart and other parts of the body. If an aneurysm in the brain bursts, it causes a stroke.

Aneurysms can develop and become large before causing any symptoms. Often doctors can stop aneurysms from bursting if they find and treat them early. They use imaging tests to find aneurysms. Often aneurysms are found by chance during tests done for other reasons. Medicines and surgery are the two main treatments for aneurysms.

Your carotid arteries are two large blood vessels in your neck. They supply your brain and head with blood. If you have carotid artery disease, the arteries become narrow or blocked, usually because of atherosclerosis. Atherosclerosis is the buildup of plaque, which is made up of fat, cholesterol, calcium, and other substances found in the blood.

Carotid artery disease is serious because it can block the blood flow to your brain, causing a stroke. Too much plaque in the artery can cause a blockage. You can also have a blockage when a piece of plaque or a blood clot breaks off the wall of an artery. The plaque or clot can travel through the bloodstream and get stuck in one of your brain's smaller arteries.

Carotid artery disease often does not cause symptoms until the blockage or narrowing is severe. One sign may be a bruit (whooshing sound) that your doctor hears when listening to your artery with a stethoscope. Another sign is a transient ischemic attack (TIA), a "mini-stroke." A TIA is like a stroke, but it only lasts a few minutes, and the symptoms usually go away within an hour. Stroke is another sign.

Imaging tests can confirm whether you have carotid artery disease.

Treatments may include

• Healthy lifestyle changes
• Medicines
• Carotid endarterectomy, surgery to remove the plaque
• Angioplasty, a procedure to place a balloon and stent into the artery to open it and hold it open

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.

CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts' blood supply, causing permanent heart damage.

Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.

Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein clots occur in the lower leg or thigh. If the vein swells, the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem in the lung, called a pulmonary embolism.

Sitting still for a long time can make you more likely to get a DVT. Some medicines and disorders that increase your risk for blood clots can also lead to DVTs. Common symptoms are

• Warmth and tenderness over the vein
• Pain or swelling in the part of the body affected
• Skin redness

Treatment includes medicines to ease pain and inflammation, break up clots and keep new clots from forming. Keeping the affected area raised and applying moist heat can also help. If you are taking a long car or plane trip, take a break, walk or stretch your legs and drink plenty of liquids.

Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly becomes blocked. Without the blood coming in, the heart can't get oxygen. If not treated quickly, the heart muscle begins to die. But if you do get quick treatment, you may be able to prevent or limit damage to the heart muscle. That's why it's important to know the symptoms of a heart attack and call 9-1-1 if you or someone else is having them. You should call, even if you are not sure that it is a heart attack.

The most common symptoms in men and women are

• Chest discomfort. It is often in center or left side of the chest. It usually lasts more than a few minutes. It may go away and come back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
• Shortness of breath. Sometimes this is your only symptom. You may get it before or during the chest discomfort. It can happen when you are resting or doing a little bit of physical activity.
• Discomfort in the upper body. You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach.

You may also have other symptoms, such as nausea, vomiting, dizziness, and lightheadedness. You may break out in a cold sweat. Sometimes women will have different symptoms then men. For example, they are more likely to feel tired for no reason.

The most common cause of heart attacks is coronary artery disease (CAD). With CAD, there is a buildup of cholesterol and other material, called plaque, on their inner walls or the arteries. This is atherosclerosis. It can build up for years. Eventually an area of plaque can rupture (break open). A blood clot can form around the plaque and block the artery.

A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery.

At the hospital, health care providers make a diagnosis based on your symptoms, blood tests, and different heart health tests. Treatments may include medicines and medical procedures such as coronary angioplasty. After a heart attack, cardiac rehabilitation and lifestyle changes can help you recover.

Heart diseases are the number one killer in the U.S. They are also a major cause of disability. If you do have a heart disease, it is important to find it early, when it is easier to treat. Blood tests and heart health tests can help find heart diseases or identify problems that can lead to heart diseases. There are several different types of heart health tests. Your doctor will decide which test or tests you need, based on your symptoms (if any), risk factors, and medical history.

Cardiac Catheterization

Cardiac catheterization is a medical procedure used to diagnose and treat some heart conditions. For the procedure, your doctor puts a catheter (a long, thin, flexible tube) into a blood vessel in your arm, groin, or neck, and threads it to your heart. The doctor can use the catheter to

• Do a coronary angiography. This involves putting a special type of dye in the catheter, so the dye can flow through your bloodstream to your heart. Then your doctor takes x-rays of your heart. The dye allows your doctor to see your coronary arteries on the x-ray, and to check for coronary artery disease (plaque buildup in the arteries).
• Take samples of blood and heart muscle
• Do procedures such as minor heart surgery or angioplasty, if your doctor finds that you need it

Cardiac CT Scan

A cardiac CT (computed tomography) scan is a painless imaging test that uses x-rays to take detailed pictures of your heart and its blood vessels. Computers can combine these pictures to create a three-dimensional (3D) model of the whole heart. This test can help doctors detect or evaluate

• Coronary artery disease
• Calcium buildup in the coronary arteries
• Problems with the aorta
• Problems with heart function and valves
• Pericardial diseases

Before you have the test, you get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures. The CT scanner is a large, tunnel-like machine. You lie still on a table which slides you into the scanner, and the scanner takes the pictures for about 15 minutes.

Cardiac MRI

Cardiac MRI (magnetic resonance imaging) is a painless imaging test that uses radio waves, magnets, and a computer to create detailed pictures of your heart. It can help your doctor figure out whether you have heart disease, and if so, how severe it is. A cardiac MRI can also help your doctor decide the best way to treat heart problems such as

• Coronary artery disease
• Heart valve problems
• Pericarditis
• Cardiac tumors
• Damage from a heart attack

The MRI is a large, tunnel-like machine. You lie still on a table which slides you into the MRI machine. The machine makes loud noises as it takes pictures of your heart. It usually takes about 30-90 minutes. Sometimes before the test, you might get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures.

Chest X-Ray

A chest x-ray creates pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. It can reveal signs of heart failure, as well as lung disorders and other causes of symptoms not related to heart disease.

Coronary Angiography

Coronary angiography (angiogram) is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. Doctors use this procedure to diagnose heart diseases after chest pain, sudden cardiac arrest, or abnormal results from other heart tests such as an EKG or a stress test.

You usually have a cardiac catheterization to get the dye into your coronary arteries. Then you have special x-rays while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.

Echocardiography

Echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart's chambers and valves are working. Doctors use an echo to diagnose many different heart problems, and to check how severe they are.

For the test, a technician applies gel to your chest. The gel helps sound waves reach your heart. The technician moves a transducer (wand-like device) around on your chest. The transducer connects to a computer. It transmits ultrasound waves into your chest, and the waves bounce (echo) back. The computer converts the echoes into pictures of your heart.

Electrocardiogram (EKG), (ECG)

An electrocardiogram, also called an ECG or EKG, is a painless test that detects and records your heart's electrical activity. It shows how fast your heart is beating and whether its rhythm is steady or irregular.

An EKG may be part of a routine exam to screen for heart disease. Or you may get it to detect and study heart problems such as heart attacks, arrhythmia, and heart failure.

For the test, you lie still on a table and a nurse or technician attaches electrodes (patches that have sensors) to the skin on your chest, arms, and legs. Wires connect the electrodes to a machine that records your heart's electrical activity.

Stress Testing

Stress testing looks at how your heart works during physical stress. It can help to diagnose coronary artery disease, and to check how severe it is. It can also check for other problems, including heart valve disease and heart failure.

For the test, you exercise (or are given medicine if you are unable to exercise) to make your heart work hard and beat fast. While this is happening, you get an EKG and blood pressure monitoring. Sometimes you may also have an echocardiogram, or other imaging tests such as a nuclear scan. For the nuclear scan, you get an injection of a tracer (a radioactive substance), which travels to your heart. Special cameras detect the energy from the tracer to make pictures of your heart. You have pictures taken after you exercise, and then after you rest.

Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of PAD is atherosclerosis. This happens when plaque builds up on the walls of the arteries that supply blood to the arms and legs. Plaque is a substance made up of fat and cholesterol. It causes the arteries to narrow or become blocked. This can reduce or stop blood flow, usually to the legs. If severe enough, blocked blood flow can cause tissue death and can sometimes lead to amputation of the foot or leg.

The main risk factor for PAD is smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, heart disease, and stroke.

Many people who have PAD don't have any symptoms. If you have symptoms, they may include

• Pain, numbness, achiness, or heaviness in the leg muscles. This happens when walking or climbing stairs.
• Weak or absent pulses in the legs or feet
• Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
• A pale or bluish color to the skin
• A lower temperature in one leg than the other leg
• Poor nail growth on the toes and decreased hair growth on the legs
• Erectile dysfunction, especially among men who have diabetes

PAD can increase your risk of heart attack, stroke, and transient ischemic attack.

Doctors diagnose PAD with a physical exam and heart and imaging tests. Treatments include lifestyle changes, medicines, and sometimes surgery. Lifestyle changes include dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure.

Pulmonary embolism is a type of venous thromboembolism (VTE) that occurs when a blood clot breaks loose and travels through the bloodstream to the lungs. Usually, pulmonary embolisms come from blood clots in the deep vein of the leg (deep vein thrombosis (DVT)).

Raynaud's disease is a rare disorder of the blood vessels, usually in the fingers and toes. It causes the blood vessels to narrow when you are cold or feeling stressed. When this happens, blood can't get to the surface of the skin and the affected areas turn white and blue. When the blood flow returns, the skin turns red and throbs or tingles. In severe cases, loss of blood flow can cause sores or tissue death.

Primary Raynaud's happens on its own. The cause is not known. There is also secondary Raynaud's, which is caused by injuries, other diseases, or certain medicines.

People in colder climates are more likely to develop Raynaud's. It is also more common in women, people with a family history, and those over age 30.

Treatment for Raynaud's may include drugs to keep the blood vessels open. There are also simple things you can do yourself, such as

• Soaking hands in warm water at the first sign of an attack
• Keeping your hands and feet warm in cold weather
• Avoiding triggers, such as certain medicines and stress

What is a stroke?

A stroke happens when there is a loss of blood flow to part of the brain. Your brain cells cannot get the oxygen and nutrients they need from blood, and they start to die within a few minutes. This can cause lasting brain damage, long-term disability, or even death.

If you think that you or someone else is having a stroke, call 911 right away. Immediate treatment may save someone's life and increase the chances for successful rehabilitation and recovery.

What are the types of stroke?

There are two types of stroke:

• Ischemic stroke is caused by a blood clot that blocks or plugs a blood vessel in the brain. This is the most common type; about 80% of strokes are ischemic.
• Hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain

Another condition that's similar to a stroke is a transient ischemic attack (TIA). It's sometimes called a "mini-stroke." TIAs happen when the blood supply to the brain is blocked for a short time. The damage to the brain cells isn't permanent, but if you have had a TIA, you are at a much higher risk of having a stroke.

Who is at risk for a stroke?

Certain factors can raise your risk of a stroke. The major risk factors include

• High blood pressure. This is the primary risk factor for a stroke.
• Diabetes.
• Heart diseases. Atrial fibrillation and other heart diseases can cause blood clots that lead to stroke.
• Smoking. When you smoke, you damage your blood vessels and raise your blood pressure.
• A personal or family history of stroke or TIA.
• Age. Your risk of stroke increases as you get older.
• Race and ethnicity. African Americans have a higher risk of stroke.

There are also other factors that are linked to a higher risk of stroke, such as

• Alcohol and illegal drug use
• Not getting enough physical activity
• High cholesterol
• Unhealthy diet
• Having obesity

What are the symptoms of stroke?

The symptoms of stroke often happen quickly. They include

• Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
• Sudden confusion, trouble speaking, or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden difficulty walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

If you think that you or someone else is having a stroke, call 911 right away.

How are strokes diagnosed?

To make a diagnosis, your health care provider will

• Ask about your symptoms and medical history
• Do a physical exam, including a check of
  • Your mental alertness
  • Your coordination and balance
  • Any numbness or weakness in your face, arms, and legs
  • Any trouble speaking and seeing clearly
• Run some tests, which may include
  • Diagnostic imaging of the brain, such as a CT scan or MRI
  • Heart tests, which can help detect heart problems or blood clots that may have led to a stroke. Possible tests include an electrocardiogram (EKG) and an echocardiography.

What are the treatments for stroke?

Treatments for stroke include medicines, surgery, and rehabilitation. Which treatments you get depend on the type of stroke and the stage of treatment. The different stages are

• Acute treatment, to try to stop a stroke while it is happening
• Post-stroke rehabilitation, to overcome the disabilities caused by the stroke
• Prevention, to prevent a first stroke or, if you have already had one, prevent another stroke

Acute treatments for ischemic stroke are usually medicines:

• You may get tPA, (tissue plasminogen activator), a medicine to dissolve the blood clot. You can only get this medicine within 4 hours of when your symptoms started. The sooner you can get it, the better your chance of recovery.
• If you cannot get that medicine, you may get medicine that helps stop platelets from clumping together to form blood clots. Or you may get a blood thinner to keep existing clots from getting bigger.
• If you have carotid artery disease, you may also need a procedure to open your blocked carotid artery

Acute treatments for hemorrhagic stroke focus on stopping the bleeding. The first step is to find the cause of bleeding in the brain. The next step is to control it:

• If high blood pressure is the cause of bleeding, you may be given blood pressure medicines.
• If an aneurysm if the cause, you may need aneurysm clipping or coil embolization. These are surgeries to prevent further leaking of blood from the aneurysm. It also can help prevent the aneurysm from bursting again.
• If an arteriovenous malformation (AVM) is the cause of a stroke, you may need an AVM repair. An AVM is a tangle of faulty arteries and veins that can rupture within the brain. An AVM repair may be done through
  • Surgery
  • Injecting a substance into the blood vessels of the AVM to block blood flow
  • Radiation to shrink the blood vessels of the AVM

Stroke rehabilitation can help you relearn skills you lost because of the damage. The goal is to help you become as independent as possible and to have the best possible quality of life.

Prevention of another stroke is also important, since having a stroke increases the risk of getting another one. Prevention may include heart-healthy lifestyle changes and medicines.

Can strokes be prevented?

If you have already had a stroke or are at risk of having a stroke, you can make some heart-healthy lifestyle changes to try to prevent a future stroke:

• Eating a heart-healthy diet
• Aiming for a healthy weight
• Managing stress
• Getting regular physical activity
• Quitting smoking
• Managing your blood pressure and cholesterol levels

If these changes aren't enough, you may need medicine to control your risk factors.

Varicose veins are swollen, twisted veins that you can see just under the skin. They usually occur in the legs, but also can form in other parts of the body. Hemorrhoids are a type of varicose vein.

Your veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.

Varicose veins are very common. You are more at risk if you are older, are female, have obesity, don't exercise, or have a family history of varicose veins. They can also be more common in pregnancy.

Doctors often diagnose varicose veins from a physical exam. Sometimes you may need additional tests.

Exercising, losing weight, elevating your legs when resting, and not crossing them when sitting can help keep varicose veins from getting worse. Wearing loose clothing and avoiding long periods of standing can also help. If varicose veins are painful or you don't like the way they look, your doctor may recommend procedures to remove them.