MedED - vascular disease Flashcards
cardiovascular risk factors
male obese elderly smoking PMH of CVD
PVD (peripheral vasc dusease)
atherosclerosis –> stenosis of arteries
types of PVD
acute - acute limb ischaemia - 4-6hrs hours to save limb
chronic - intermittent claudication(pain at exercise) and clitical limb ischaemia (pain at rest)
arterial ulcers
gangrene
Fontaine stages of severity of PVD
Grade 0, Category 0: asymptomatic
Grade I, Category 1: mild claudication
Grade I, Category 2: moderate claudication
Grade I, Category 3: severe claudication
Grade II, Category 4: rest pain
Grade III, Category 5: minor tissue loss; ischemic ulceration not exceeding ulcer of the digits of the foot
Grade IV, Category 6: major tissue loss; severe ischemic ulcers or frank gangrene
leriche sydrome
aortoiliac occluisve disease
absent weak distant pulses
and other
Buerger’s angle
leg should remain pink even at 90 degrees when lying down
severe limb ischaemia if pain becomes ischaemic at 20 degrees
Something about dangling leg
acute limb ischaemia - 6 Ps
pain pale pulseless perishingly cold paralysis paraesthesia
ABPI
ankle brachial pressure index - systolic ankle pressure divided by brachial systolic. If less than 0.5 then severe ischaemia of limb
colour duplex US
duplex shows colour of vessels
ulcers
loss of continuity of epithelium/endothelium
types of ulcers
arterial - inadequate supply
venous - incompetent valves, obstruction
neuropathic - peripheral neuropathy typically in diabetic pts
which are more common - arterial or venous?
venous
arterial are only 10-30%
arterial ulcers symptoms
punched out appearance distal well defined deep night pain pale base - grey granulation tissue
venous ulcers symptoms
large shallow more proximal medial gaiter region (halfway down calf) painless
lipodermatosclerosis AKA? (venous)
inverted champagne bottle sign
