Circulatory disorders are defined as impaired blood supply in certain areas of the body. The extremities (arms, legs) are most frequently affected by poor circulation. However, the heart, intestines and brain can also be affected. The lack of oxygen supply restricts their function and, in the worst case, they can die. Here you will find further information and selected doctors for circulatory disorders.
Doctors differentiate between
circulatory disorders.
Arteries are blood vessels through which oxygen-rich blood is pumped from the heart through the body. Veins, on the other hand, carry the blood back to the heart after the oxygen has been delivered.
An arterial circulatory disorder (also known as arterial occlusive disease ) occurs when an artery is narrowed or even blocked. Peripheral arteries (e.g. in the legs) or central arteries supplying organs (e.g. coronary, renal and intestinal arteries) can be affected.
If the blockage or constriction is in a vein, this is referred to as a venous circulatory disorder - this includes deep vein thrombosis and varicose veins, for example.
In a heart attack, muscle tissue dies, which means that the heart no longer functions correctly © Henrie | AdobeStock
An acute circulatory disorder is present when symptoms occur due to a sudden vascular occlusion. An acute vascular occlusion can be a medical emergency, depending on the organ affected. Immediate emergency medical measures are then required. Such emergencies include
A chronic circulatory disorder usually develops over a longer period of time. Depending on the area of the body affected, various symptoms can occur.
The cause of an acute circulatory disorder is a vascular occlusion caused by a thrombus or embolus.
A thrombus is a blood clot in a vessel, i.e. a small blood clot that can block the vessel. An embolus is when such a thrombus becomes detached, is washed away and blocks the vessel again at another location.
A vascular occlusion caused by a thrombus is called a thrombosis and one caused by an embolus is called an embolism. A blood clot can occur, for example
arise spontaneously.
A chronic circulatory disorder is usually caused by narrowing(stenosis), more rarely also by occlusion of a vessel. Vascular constriction can occur if the vessel is either kinked or is compressed from the outside by an anatomical structure.
Other causes of chronic circulatory disorders:
In most cases, arteriosclerosis (colloquially known as hardening of the arteries) is responsible for the formation of constrictions. In arteriosclerosis, the inner walls of the arteries are covered with cholesterol deposits (plaques). They increase in size over the years and can therefore impair blood flow. Less and less blood can then pass through the constriction. Blood clots can also get stuck here, leading to acute vascular occlusion.
Illustration of a vasoconstriction due to arteriosclerosis © peterschreiber.media | AdobeStock
In chronic arterial circulatory disorders, new blood vessels can form that bypass the constricted area. They thus take over the supply of sufficient oxygen and nutrients for a certain period of time.
Depending on where the vascular occlusion or constriction occurs, different clinical pictures can develop:
In principle, any vessel and therefore any organ can be affected by a vasoconstriction or occlusion. In peripheral arterial occlusive disease (PAOD) (colloquially known as intermittent claudication), the peripheral vessels, usually in the legs, are constricted or blocked, so PAOD can be chronic or acute.
The most important risk factors for arteriosclerosis as the main cause of a circulatory disorder include
Other risk factors for the formation of a thrombus (embolus) are, for example
The type of symptoms depends on various factors, such as
An acute vascular occlusion in the extremities causes
There is no pulse in the affected areas. Any wounds no longer heal. If internal organs such as the intestines are affected, the result is an intestinal infarction with very severe abdominal pain. In extreme cases, this can result in intestinal paralysis.
In Raynaud's syndrome, a harmless circulatory disorder, toes and fingers are insufficiently supplied with blood for a short time. They first turn white and then bluish in color, but blood flow resumes after a short time.
Raynaud's syndrome
If the patient suffers from peripheral arterial occlusive disease, the legs are usually poorly supplied with blood. As the muscles are undersupplied, the patient is in pain and has to stand still at certain intervals ("intermittent claudication"). In a later stage of the occlusive disease, severe tissue damage up to the smoker's leg is the result.
If the heart is affected by chronic circulatory disorders, the patient develops coronary heart disease (CHD). This manifests itself in the form of more or less severe heart pain and, in the worst case, a heart attack.
Venous inflammation only affects the legs. They become thick, feel hot and are sensitive to pressure. Reddening of the skin occurs in the affected areas.
The pain associated with phlebitis can be alleviated by elevating the legs. In contrast to arterial circulatory disorders, the pulse in the legs can still be felt.
Chronic circulatory disorders should also be treated by an experienced doctor. If you experience one or more of the symptoms listed, you should consult an angiologist (specialist in vascular diseases) as soon as possible.
Once the preliminary examinations have been completed, the specialist will check his suspected diagnosis using various methods.
The blood test provides information on how high the blood lipid and blood sugar levels are and is used to determine the coagulation factors. This enables the doctor to recognize which risk factors are relevant for the patient.
If the blood pressure measurement shows different values for both arms or legs, this indicates a one-sided narrowing of the blood vessels.
Circulatory disorders in the leg can be detected by determining the ankle-brachial index (ABI, Doppler index). To determine it, the blood pressure value determined at the patient's ankle is divided by the value at the upper arm. Values below or equal to 0.92 are indicative of peripheral arterial occlusive disease.
Various other physical tests can also provide indications of circulatory disorders. These include, for example
While the first two tests assess skin discoloration (redness, fading), the walking test looks at whether and when pain occurs in the legs.
Conclusions about the blood flow to the tissue can be drawn indirectly by means of transcutaneous oxygen partial pressure measurement . Sensors on the skin measure the oxygen content in the tissue.
Various methods can be used in the field of imaging. A special ultrasound device determines the flow speed and direction of the blood within the arteries(Doppler and duplex sonography).
Computed tomographic angiography(CTA) can be used to visualize the vessels very well.
are available. The latter is also frequently used as part of vascular surgery. These procedures can be used to locate constricted areas in the vessels. By administering a contrast agent, the vessels and the constrictions can be identified even more precisely.
Angiography can visualize blood vessels © Ploypilin | AdobeStock
The treatment of impaired blood circulation is
Specialists in circulatory disorders are angiologists, phlebologists, vascular surgeons and cardiologists when it comes to the coronary vessels.
Varicose veins are a common form of circulatory disorder in the legs © zlikovec | AdobeStock
An acute vascular occlusion is often a medical emergency. It requires immediate surgical intervention to restore the patency of the vessel (revascularization). Intensive medical care is then also required. The same can sometimes be the case with chronic vascular diseases.
A blood clot can be surgically removed and the vessel reopened. During a thrombendarterectomy, the arteriosclerotic changes in the vessel wall are removed in addition to the blood clot (exfoliation surgery). To dilate a narrowed vessel, the vascular surgeon inserts balloon catheters or stents (wire sleeves), which may be coated with medication. By placing a vascular bypass, which is a type of vascular implant, the blocked area of the vessel is bypassed.
Various substances (fibrinolytics) can be injected to dissolve a thrombus (lysis treatment), such as
In certain cases, heparin is also administered.
In the event of a very severe circulatory disorder and prolonged undersupply, the tissue dies. This makes it necessary to amputate the affected limb.
The following are used for drug therapy and to prevent thrombosis
medications are used. If the patient is in pain, the doctor will also prescribe painkillers or inject morphine (in severe cases).
In the case of chronic PAD, special supervised walking and vascular training as well as moderate sporting activities (swimming, cycling) can help. This can improve the oxygen supply to the affected part of the body. Warm arm baths increase blood circulation.
For causal therapy and to prevent the condition from worsening, the doctor recommends that the patient eliminates the risk factors:
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