Peripheral Arterial Disease (PDA) Flashcards
What is Peripheral Arterial Disease (PAD)?
Circulation issue where arteries narrow + reduce blood flow to the limbs
PAD can lead to serious complications if untreated.
What are the three main presentations of Peripheral Arterial Disease?
- Intermittent claudication
- Critical limb ischaemia
- Acute limb-threatening ischaemia
Each presentation indicates a different severity of the disease.
What are the risk factors for Peripheral Arterial Disease?
- Age
- Smoking
- Diabetes (T1 and T2)
- Hypertension
- Dyslipidaemia
- Atrial fibrillation (AF)
- Family history
Multiple risk factors can compound the likelihood of developing PAD.
What is the pathophysiology of Peripheral Arterial Disease?
Plaque build up –> Atherosclerosis –> stenosis or occlusion
This process leads to reduced blood flow and oxygen to the limbs.
What are common symptoms of Peripheral Arterial Disease?
- May be asymptomatic
- Intermittent claudication
- Hair loss
- Brittle/slow-growing toenails
- Ulcers
- Pale, blue, shiny skin
- Muscle wasting
- Erectile dysfunction in men
Symptoms can vary greatly among individuals.
What investigations are used to diagnose Peripheral Arterial Disease?
- Doppler ultrasound
- Ankle-brachial pressure index (ABPI) measurements
- Magnetic Resonance Angiography (MRA)
ABPI < 0.9/0.8 indicates significant PAD.
What are the lifestyle treatments for Peripheral Arterial Disease?
- Healthy diet
- Weight loss
- Lower alcohol intake
- Stop smoking
Lifestyle changes can significantly improve symptoms and outcomes.
What is the first-line pharmacological management for Peripheral Arterial Disease?
- Clopidogrel (Aspirin if contraindicated)
- Statin
- Good hypertension and diabetes control
- Improve blood supply with Naftidrofuryl oxalate
Medications aim to improve blood flow and manage risk factors.
What are the complications associated with Peripheral Arterial Disease?
- Acute and critical limb ischaemia
- Gangrene
- Increased risk of cardiovascular disease (stroke, myocardial infarction, angina, acute coronary syndrome)
- Systemic atherosclerosis
Complications can lead to severe morbidity and mortality.
What is Chronic/Critical Limb Ischaemia?
Most severe stage of Peripheral Arterial Disease
This stage requires urgent medical attention to prevent severe complications.
What are the symptoms of Chronic/Critical Limb Ischaemia?
- Rest pain for 2+ weeks
- Non-healing wounds/ulcers
- Gangrene
Symptoms often indicate a critical lack of blood flow.
What investigations indicate Critical Limb Ischaemia?
ABPI < 0.5
Other investigations include Doppler ultrasound and MR angiography.
What are the complications of Critical Limb Ischaemia?
- Sepsis (secondary to infected gangrene)
- Acute-on-chronic ischaemia
- Amputation
- Reduced mobility and quality of life
These complications can drastically affect a patient’s health and lifestyle.
