Peripheral arterial disease Flashcards
What is peripheral arterial disease?
Narrowing of the arteries supplying the limbs + peripheries hence reducing blood supply.
What is the main symptom of peripheral arterial disease?
Claudication - intermittent crampy, aching pain in the leg that occurs on exertion.
What is critical limb ischaemia?
End stage peripheral arterial disease
Inadequate blood supply at rest
How does critical / chronic limb ischaemia present?
6 Ps - Pain Pallor Pulselessness Paralysis Paraesthesia / pins + needlse Perishing cold
Also with ulcers and gangrene
What is the main cause of acute limb ischaemia?
A thrombus (clot) blocks the arterial supply of the distal limb - this may have embolised from elsewhere
What is the difference between necrosis and gangrene?
Both refer to death of tissue, but gangrene is specifically due to inadequate blood supply.
What is ischaemia?
inadequate oxygen to tissue due to reduced blood supply.
What is atherosclerosis?
Thickening + stiffening of arteries due a build up of plaques in the walls (fatty deposits /lipids)
What are some risk factors for atherosclerosis?
Old age Family history Male Smoking High alcohol intake Poor diet - high in sugar + trans fats Sedentary lifestyle Obesity Stress
What are some complications of atherosclerosis?
Angina MI (heart attack) TIA stroke Peripheral arterial disease Chronic mesenteric ischaemia
What is Leriche Syndrome and how does it present?
Occlusion of the distal aorta / proximal common iliac artery. Presents with - thigh/buttock claudication - absent femoral pulses - male impotence
What are some signs of arterial disease on inspection?
Skin pallor Cyanosis Muscle wasting Hair loss Ulcers Poor wound healing Gangrene
What may be seen on examination in arterial disease?
Reduced skin temperature Reduced sensation (parasthesia) Prolonged capilliary refill (> 2 seconds)
What causes arterial ulcers?
Ischaemia secondary to an inadequate blood supply
What causes venous ulcers?
Impaired drainage and pooling of blood