PAD/AOD Flashcards
CAD Risk Factors
- Smoking
- Dyslipidemia
- HTN
- Hyperhomocysteinemia
Atherosclerosis Risk Factors
- 70 yo
- claudication/ischemic rest pain
- abnormal LE pulses
- Smoker/used to smoke
- Diabetes
- HTN
- high cholesterol
- Hx vascular disease, MI, stroke
- African American
S/Sx
- intermittent claudication
- leg/foot pain disrupting sleep
- sore/wound on feet
- paleness/blueness
- decreased temp
- poor nail growth
- decreased hair growth on LE
- may be asymptomatic
PAD
obstruction of large to medium sized arteries by atheromatous plaques
- mostly LE
- unilateral
ABI
- compare LE & UE SBP with hand held doppler
- ABI=SBP leg/SBP arm
Leg: use dorsalis pedis/post tib
ABI Classification
> 1.3: non compressible (diabetes, ESRD)
1.0-1.29: normal
- 91-0.99: borderline
- 41-0.9: mild-mod PAD (diagnose at 0.9)
0-0.4: Severe PAD
Ex's Rx: F: I: T: T:
F: 1-2x/day; 7 days/week
I: 3+/4 PVD for as long as possible
T: walking, bike (large Mm groups)
T: Intervals, progress to 30-60 min continuous
PVD Scale
0: no claudication pn
1: definite discomfort/pain
2: moderate pain; can distract from pain
3: intense pain; can’t distract (but keep exercising)
4: excruciating/unbearable (stop test/ex’s)
PAD Ex’s Test Choice
6MWT with PVD Scale
Chronic Venous Symptoms
- calf, lower leg
- tired, achy, fullness
- chronic pain increasing through day
- increased with prolonged sitting/standing
- decr with feet up, lying down, walking
- edema, varicose Vv
Population at risk for Chronic venous problems
- pregnant
- obese
- prolonged sitting/standing at job
- prolonged bed rest
- CHF
- thrombophlebitis
- varicose Vv
- insult to Vv
Acute Arterial Sx
- distal to occlusion
- throbbing
- sudden onset (w/n 1 hour)
- 6 Ps: pain, pulselessness, pallor, paresthesia, paralysis, poikilothermia
6 P’s of Acute Arterial Disorders
- pain
- pulselessness
- paresthesia
- poikilothermia
- pallor
- paralysis
Populations at risk for acute arterial disorders
- post vascular surgery
- trauma
- chronic A fib
- clot patients
Benefits of ex’s with PAD
- incr collateral circulation
- incr muscular efficiency
- incr pt tolerance of anaerobic ex’s
- incr pn threshold
- decr blood viscosity
