Arterial disease of the limbs- presentation, investigation and therapy Flashcards
what are the symptoms of chronic limb ischaemia
intermittent claudication
cramp like pain in muscles that occurs on exercising
what are the symptoms of chronic limb ischaemia
intermittent claudication
cramp like pain in muscles that occurs on exercising
what are the symptoms of critical limb ischaemia
rest pain
ulceration and gangrene
what is the pathogenesis of PAD
atherosclerosis
diabetes mellitus
what are rare causes of PAD
beurgers disease
hyperhomocysteinaemia
patients with PVD (PAD) should be managed in the same way as those with what condition
Chronic heart disease
what are some of the risk factors of developing PAD/PVD
smoking not enough exercise diabetes hypertension excessive lipids in the blood
what would you prescribe to manage risk factors to a patient already diagnosed with PAD
aspirin
statin
ACE inhibitor
what is the single most powerful risk factor associated with the aetiology and progression of peripheral arterial disease
smoking
if a patient stopped smoking how long would it take for their excess risk of cardiovascular disease to disappear
4-6 years
how does diabetes influence PAD
makes it more severe
why is it important to screen for diabetes in patients with PAD
as up to 10% attending the clinic are undiagnosed diabetics
what do statins inhibit
plaque rupture
platelet activation & thrombosis
endothelial activation
what is the blood pressure target for patients with hypertension
what is the modern secondary prevention management of peripheral arterial disease (5 things)
Anti-platelet therapy- clopidogrel 2nd line Statin- for all Screen for diabetes Smoking cessation BP control: BP
what can help improve symptoms in those with PAD
medicine
exercise therapy
angioplasty
surgery
what effects does doing exercise have on patients with PAD
improves BP
improves dyslipidaemia
improves endothelial function
what can surgery do in those with PAD to manage symptoms
very little as extensive disease is not suitable for percutaneous transluminal coronary angioplasty
in patients with PAD who is suitable for surgery
those who currently have a poor QOL
have acceptable co-mobidity
clear understanding of the risks of surgery
what is the modern management for critical limb ischaemia
first line secondary prevention and surgery,angioplasty, amputation
in critical limb ischaemia what signs show the limb is at risk
presence of rest pain
ulcers gangrene
in patients with critical limb ischaemia what is the 5 year survival rate
50% still alive at 5 years
how do you tell if acute limb ischaemia is due to an emblous
if all pulses are present in contralateral limb and there is atrial fibrillation, suggests embolus
how do you tell if ischaemia is due to in situ thrombosis
presence of intermittent claudication suggests in situ thrombosis
