peripheral artery disease & peripheral vascular disease Flashcards
what is peripheral artery disease ?
involves thickening of artery walls, that results in narrowing of the Arties of the upper and Lower extremities
the following flashcards are going to be based on PAD
what is the leading cause of PAD?
atherosclerosis
a gradual thickening of the intima usually results from the high cholesterol and it sticking to the artery causing plaque and build up
what is the biggest clinical manifestation that is often associated with peripheral artery disease?
intermittent claudication
how does intermittent claudication occur?
its pain in the muscles during exercise or activity, resulting from inadequate blood flow
what do we recommend patients to do when they are expericing intermittent claudication ?
to rest for about 10 minutes
something important to note is that if a patient is experiencing intermittent claudication and we want to test this out in a lab or possible doctors office, can it be reproducible ?
yes
patients with PAD, often also experience rest pain, in which when they are laying down, they feel this numbnesss and burning feeling, what do we often tell patients to do when they feel like this ?
remember the finger motion
dangle their feet down, in order to promote blood flow down to the legs
more than often, the patient will have what type of skin ( feeling & color )?
dry, scale skin & cold/gray skin
when a patient with PAD has their legs elevated, what skin color
when a patient with PAD has their legs dangling, what skin color
what does their skin feel like
how does their skin look like
grey
rubor ( red color )
cold
thin, shiny taut
another key thing that happens is something that can be seen on the feet, what are the 2?
thickened toe nails & painful or non painful sores between the toes or on the upper aspect of the foot
last but not least, something that happens differently with PAD vs PVD, is that more than likely you are not going to see what on the patients leg?
hair
alright, we discussed all the main clinical manifestations, can you recall them ? (8)
interimmeint claudication
rest pain = need to dangle for comfort
dry, scale, grey skin color
thickened toe nails
painful or not painful sores
no hair
no peripheral pulses
cold, shiny, thin, taut skin
what is the capillary refill time when it comes to PAD?
do patients with PAD feel itchy?
do patients with PAD have edema?
greater than 3
no
no
what is the main diagnostic tool we use for someone with pad?
ankle branchial index
notes
- typically we encourage patients to reduce CVD risk factors, like avoiding salt and getting on a DASH diet
- avoiding smoking
- regular exercise
- tight blood pressure control
what type of medications do we usually prescribe patients with PAD?
ace inhibitors
aspirin
statins
two main drugs to treat intermittent claudication are ?
clopidogrel (plavix)
omeprazole ( priolsec )
notes
lastly for PAD, we can also perform surgery, such as atherectormy or a percutaneous transluminal angioplasty
the following flashcards are now going to be talking about peripheral vascular disease
what does peripheral vascular disease mean
- remember this is a generalized term to describe any venous insufficiency issue
venous insufficiency results from prolonged venous hypertension, which stretches the veins and damages the valves
the amount of venous hypertension prolongation, that stretches the veins and damage the valves, often present itself physical on a patient how?
with the result edema, venous stasis ulcers and swelling
- typically can also be seen with varicose veins too
how does the skin color look with PVD?
how does the skin feel with PVD?
is there hair on the skin with PVD?
brown pigmentation
warm
thick, hardened, and indurated
is there itching with PVD?
how does the pain feel ?
how does the toenails look like ?
super
dull ache, or heaviness in calf or thigh
normal or thickened
