Arterivaiguste

Arterivaiguste is a medical term used to describe episodes of constriction or narrowing within one or more arteries, leading to reduced blood flow to supplied tissues. The condition can be episodic or persistent and may affect any vascular bed, including peripheral, cerebral, or coronary arteries. It can occur as a primary phenomenon, without an identified triggering disease, or secondary to other conditions or exposures.

Pathophysiology involves hyperreactivity of vascular smooth muscle and dysregulation of endothelial factors. Increased production of vasoconstrictors such as endothelin-1 and reduced availability of vasodilators like nitric oxide can promote arterial narrowing. Autonomic nervous system imbalances, inflammatory processes, and genetic predispositions may contribute. Triggers commonly include cold exposure, emotional or physical stress, nicotine or stimulant use, certain medications, and, in some cases, underlying diseases such as migraines or subarachnoid hemorrhage.

Clinical presentation varies with the affected vessels. Peripheral arterial involvement may cause transient pallor, cyanosis, numbness, coldness, and pain in fingers or toes. Cerebral artery vasospasm can present as sudden headaches, visual changes, or focal neurologic deficits. Coronary vasospasm often causes chest pain at rest and may mimic angina.

Diagnosis relies on clinical history and targeted imaging. Doppler ultrasound, angiography, or transcranial Doppler can demonstrate reduced blood flow or vessel narrowing. Laboratory studies help exclude alternative causes such as thrombosis or embolism.

Treatment aims to prevent episodes and relieve acute vasoconstriction. Acute management uses vasodilators (for example, nitrates or calcium channel blockers) and removal of triggers. Long-term strategies focus on risk factor modification (smoking cessation, temperature protection) and, when appropriate, ongoing vasodilator therapy. The prognosis depends on cause, frequency of episodes, and the risk of tissue injury during prolonged ischemia.