Large vessel disease is a very dangerous group of diseases with rapid onset, rapid progression and high mortality rates. The large blood vessels mentioned here mainly refer to the aorta – the most important artery in the body. In terms of appearance, these vessels are large in caliber and thick in diameter; in terms of function, the functional role of these vessels is also great, and the blood supply of all tissues and organs in the human body comes from it. 1. Etiology Large blood vessel diseases are divided into two major categories: stenotic and dilated ones. The cause of stenosis can be congenital (aortic constriction) or acquired (luminal narrowing or occlusion caused by syphilis, tuberculosis, arteritis, trauma, rheumatic fever, atherosclerosis, etc.). Dilated macrovascular disease is what we commonly refer to as aneurysms. Its causes include Marfan syndrome (congenital), syphilis or bacterial infection, atherosclerosis, hypertension, trauma, etc. 2, symptom performance Large vessel disease is divided into two categories: stenotic and dilated. The clinical manifestations of stenotic macrovascular diseases depend on the blood supply organ corresponding to the stenosis site. Aortic stenosis mainly manifests as hypertension and congestive heart failure. If the blood supply to the brain is involved, it may manifest as dizziness, headache, tinnitus, visual impairment, speech impairment, or even blurred consciousness and paralysis; if the blood supply to the limbs is affected, it may manifest as pain and intermittent claudication. Dilated macrovascular disease is what we usually call aneurysm. Based on the pathological changes, aneurysms are classified as true aneurysms, pseudoaneurysms and aortic coarctation. True aneurysms and pseudoaneurysms mainly present with symptoms of compression of adjacent organs, such as hoarseness, dysphagia, wheezing, etc. Sometimes, one can feel abnormal pulsation of blood vessels or palpate a mass by oneself. The typical presentation of aortic coarctation is sudden onset of severe pain in the chest and back, often described as “tearing” pain, accompanied by pallor, sweating, fainting and even stroke. Large-vessel aneurysms, also known as human “time bombs,” are extremely dangerous to human life and often lead to sudden death due to rupture and bleeding of the aneurysm. The mortality rate is 36-72% within 48 hours after the formation of a coarctation aneurysm, and only 8% of untreated patients can survive for more than one month. 3. Diagnostic tests: In aortic sinus aneurysms that rupture into the right ventricle, tremors and rough grade IV continuous murmurs are felt between the 3rd and 4th ribs at the left edge of the sternum and conducted toward the apex of the heart; in those that rupture into the right atrium, tremors and murmurs are biased toward the middle or right edge of the sternum. There may be peripheral vascular signs such as widened pulse pressure, watery pulse, and gunshot sound, and there may be signs of right heart failure such as hepatomegaly. Electrocardiogram: left-sided electrical axis, left ventricular hypertension, hypertrophy or right and left ventricular hypertrophy. x-ray: enlarged cardiac shadow, prominent pulmonary artery segment, hilar congestion, and deepened lung striae. Echocardiography: The diseased aortic sinus shows a limited bulge with interrupted waveform, which disengages into the right ventricular outflow tract or the lower edge of the right atrial septum in diastole. Two-dimensional rupture of the aortic sinus malformation may be demonstrated. Doppler confirms the presence of a shunt. The diagnosis is based on the history, the nature and direction of conduction of the heart murmur. The diagnosis can be made by combining ECG, X-ray and echocardiography. The differential diagnosis is required for arteriovenous catheterization, high ventricular septal defect with aortic valve insufficiency, coronary artery fistula, and left coronary artery originating from the pulmonary artery. Careful analysis of the signs combined with echocardiography is not difficult to differentiate. Retrograde ascending aortography is characterized by enlarged right coronary or non-coronary sinus malformation, early visualization of the right ventricular outflow tract and pulmonary artery or right atrium, which can be distinguished. 4.Complications There are various classifications of macrovascular diseases, and different classifications contain various concentrations, so the complications of macrovascular diseases cannot be generalized, but vary according to the diseases. 5.Treatment Currently, there are two main types of repair treatment for large vessel disease: surgery and endovascular stenting: in general, endovascular stenting can be considered for either aortic coarctation or aneurysm, where the lesion is in the descending aorta; surgery can be considered for patients whose lesions are in the ascending aorta and arch, as well as those who are not suitable for endovascular stenting. Endovascular repair is the use of a metal stent to plug a clogged breach or to reinforce the arterial wall, which is a less invasive and less risky procedure. Surgical operation is to replace the diseased blood vessel with artificial blood vessel, which is more traumatic and risky, but the treatment is more thorough. 6, preventive care (1) antihypertensive treatment. It is the key to the acute stage, and is also a very effective treatment, which can often greatly improve the survival rate of patients. Commonly used are sodium nitroprusside, etc. (2) Absolute bed rest, pain relief, sedation is an important adjunct to antihypertensive treatment, and morphine-like drugs can be given when the pain is severe. (3) Closely observe the change of condition and deal with complications at any time. Closely observe the patient’s heart rate, blood pressure, respiration and their changes to understand the effect of drug treatment, pay close attention to the patient’s mental and neurological conditions, pay attention to the symmetry of the blood pressure and pulse of the limbs, pay attention to the changes in ECG and urine volume, and promptly perform echocardiography, MRI or aortography DSA examination when the condition is relatively stable to make a clear diagnosis in a timely manner.