Macrovascular dysfunction or macrovascular disease in sickle cell disease patients is characterized by the disease of the large or macro blood vessels in the body. This large blood vessel includes the aorta, the coronary arteries, peripheral arteries, cerebrovasculature, and the sizable arteries in the brain and in the limbs.
Early microvascular dysfunction is associated with an atherosclerotic plaque in the vasculature that supplies blood to the heart, brain, limbs, and other organs. Macrovascular dysfunction results from atheromatous changes in large and medium-sized blood vessels that may become totally or partially blocked. The resulting effect can affect the cardiovascular system (that causes angina or chest pain and coronary thrombosis), the cerebrovascular system (that causes stroke), and the peripheral blood supply to the lower limbs (causing claudication and tissue damage).
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Macrovascular disease or dysfunction could sometimes occur when there are blood clots built up in the large blood vessels and then further stick to the vessel walls, or it could occur due to extended or overstayed diabetes in patients with sickle cell disease.
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Macrovascular disease or dysfunction is also known as macroangiopathy refers to atherosclerosis. Atherosclerosis is a form of arteriosclerosis (the thickening and hardening of arterial walls) characterized by plaque deposits of lipids, fibrous connective tissue, calcium, and other blood substances.
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Macrovascular dysfunction is associated with the development of coronary artery disease, peripheral vascular disease, brain attack (stroke), and an increased risk of infection. Signs and symptoms of macrovascular dysfunction are sudden onsets of a focal neurologic deficit such as facial drooping, hemiparesis, or isolated weakness of arm, leg, or limb, dizziness, slurred speech, gait difficulties, and visual loss, hypertension (high blood pressure), and dyslipidemia.
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The diagnosis of macrovascular dysfunction is by several imaging studies when symptoms have been developed and can be confirmed using a computed tomography scan CT scan, or a magnetic resonance imaging MRI. CT angiography can be used to identify the location of vascular occlusion and assess for salvageable brain tissue. Peripheral arterial disease is diagnosed by determining the ankle-brachial index ABI.
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