Peripheral Arterial disease Flashcards
1
Q
Factors that suggest PAD
A
- Abnormal physical
- Pt w/ lower extremity complaints (claudication in legs: pain upon exertion)
- Pts 70
- Pts w/ evidence of atherosclerotic disease (CAD, aneurysms)
2
Q
Ankle-brachial index (ABI)
A
- The lower the ABI the greater the risk of CV event
- Highes ankle BP/highest brachial BP
- Should be above .9
- If above 1.4 that means the ankle vessels are calcified and incompressible
3
Q
Significance of PAD
A
- Pts w/ symptomatic or asymptomatic PAD generally have widespread arterial disease and thus have high risk for stroke, MI, etc
- Pts w/ PAD should be treated the same as pts that just had an MI (high risk)
- Only stable claudication PAD pts have positive prognoses (73)
- Asymptomatic pts and symptomatic pts have similar mortality rates
- Majority of fatal events are cardiac related (MI)
- Therefore must Rx low ABIs very aggressively
4
Q
Risk factors for PAD
A
- Age, gender
- Smoking (most important)
- Diabetes/blood glc
- HTN
- High LDL, low HDL
- CRP
- Obesity, lack of exercise
5
Q
Rx of PAD
A
- Rx it like severe CAD
- Risk factor modification (smoking cessation, exercise)
- 2 antiplatelets (ASA + clopidogrel)
- High dose statin
- ACE inh
- BB
- Surgical Rx: revascularization and amputation (last options)
