Cardio week: Peripheral vascular disease, abdominal aorta Flashcards
Arterial types of PVD
- occlusive arterial disease
- arterial ulceration
- carotid disease (stenosis)
- aneurysms
Venous types of PVD
- venous insufficiency (due to varicose or venous ulceration)
- venous thrombosis
Difference between thrombus and embolus
Thombus = clot
Embolus = anything (includes thrombus)
Risk factors for PVD
- smoking
- diabetes
- age
- hypertension
- hyperlipidaemia
- obesity
- heart disease
- previous DVT
- previous vascular surgery
Describe Leriche’s syndrome
(occurs in males)
- Claudication of buttocks and thighs
- Absent/decreased femoral pulses
- Erectile dysfunction
How to tell difference between arterial and venous leg ulcers:
Think of:
- site
- edge
- depth
- base
- swelling
- temperature
Site: arterial in pressure areas, venous in medial or lateral or malleoli/gaiter areas
Edge: arterial - regular. venous - irregular
Depth: arterial - deep. venous - superficial
Base: arterial - green or black. venous - pink (but may have yellow-green slough)
Swelling: absent in arterial. often present in venous
Temperature: arterial -cold. venous -warm.
6 “P”s that indicate sudden loss of blood supply
- Pale
- Pulseless
- Painful
- Parasthesia (pins and needles)
- Paralysis
- Perishingly cold
Does acute limb ischaemia happen more often with embolus or thrombus?
Embolus
if thrombus, usually pt will have experienced intermittent claudication for a while
What sort of diameter would classify enlarged blood vessel as an aneurysm
More than 1.5x its normal diameter
What clinical presentation may indicate an AAA
Sudden onset abdominal/ back pain
Classical features of DVT
- calf pain/ tenderness
- pyrexia
- persistent tachycardia
Risk factors for DVT
- immobilisation
- previous surgical procedure/ trauma
- malignancy
- heart failure
- previous DVT
- pregnancy
- oral contraceptives
Describe Buerger’s test
- Elevate pt’s leg slowly while pt lies flat
- Point at which foot goes pale is Buerger’s angle
- Move patient to sitting position, lower foot to foor
- Observe if foot goes abnormally bright red (specific sympathetic response in critical limb ischaemia)
What does ABPI >1.3 indicate
Calcified vessels/ diabetic patient
What does ABPI between 0.9-1.2 indicate
Normal vessels
