Match each clinical vignette describing a patient's physical examination and historical findings with the most accurate description of the underlying vascular pathology.
- A 65-year-old man presents with buttock and thigh claudication, bilaterally absent femoral pulses, and newly developed erectile dysfunction.Severe atherosclerotic occlusion of the distal abdominal aorta and common iliac arteries
- A 34-year-old woman presents with a unilateral headache, a pulsatile neck mass, and ipsilateral ptosis and miosis following a hyperextension injury to the neck.Intimal tear leading to intramural hematoma formation in the cervical vessels
- A 70-year-old man presents with acute, tearing periumbilical pain radiating to the back, profound hypotension, and a palpable, expansile abdominal mass.Transmural degeneration and free rupture of the infrarenal aorta
- A 45-year-old woman experiences left arm claudication, dizziness during left arm exercise, and a 30 mm Hg systolic blood pressure difference between her upper extremities.Retrograde blood flow in the vertebral artery secondary to proximal vessel stenosis
Answer
Leriche syndrome matches with aortoiliac occlusion; carotid dissection matches with intimal tearing; ruptured AAA matches with infrarenal aortic degeneration; and subclavian steal syndrome matches with retrograde vertebral flow.
Each clinical vignette provides hallmark physical and historical findings of specific vascular emergencies. Accurate diagnosis requires matching the symptoms (such as Horner syndrome, erectile dysfunction, or vertebrobasilar insufficiency) to the underlying anatomic and pathologic derangements affecting the vascular tree.
Step-by-Step Solution
Key Concept
Clinical recognition and pathophysiology of major vascular syndromes