peripheral vascular disease Flashcards
what is peripheral vascular disease
characterised by narrowing and in final stages occlusion of the peripheral arteries due to atherosclerotic plaques
where does peripheral vascular disease most commonly affect
the legs
what is the aetiology of peripheral vascular disease
atherosclerosis
common risk factors are: smoking, diabetes, hypercholesterolaemia and hypertension
what is the clinical presentation of peripheral vascular disease
intermittent claudication
can cause severe limb ischaemia
describe intermittent limb claudication in peripheral vascular disease
occurs when insufficient blood reaches exercising muscle due to atherosclerosis in the arteries
classic presentation is exertional discomfort, most commonly in the calves and relieved by rest
describe peripheral vascular disease in a pt with severe disease or critical limb ischaemia
obstruction to blood flow in the artery is compromised to a point where the blood is unable to maintain oxygenation of the tissue at rest - chronic hypoxia
needs urgent attention
describe the clinical presentation of peripheral vascular disease in a pt with severe disease or critical limb ischaemia
pain at rest
ulceration
tissue necrosis
diminished/ absent peripheral pulses
poor tissue nutrition (lack of hair/ nails/ shiny skin)
what investigations are used in peripheral vascular disease
ABPI
imaging if revascularisation is being considered
what is the management for peripheral vascular disease
lifestyle advice: smoking cessation, supervised exercise programme, advise weight loss if appropriate
control risk factors (e.g. diabetes, hypertension)
if very severe symptoms or if tissue damage is present - angioplasty or bypass graft
vasodilator therapy if pt is reluctant to undergo interventional treatment
amputation in severe critical limb ischaemia
