Peripheral Vascular Disease Flashcards
What is the typical history associated with peripheral vascular disease?
Intermittent claudication: pain in the legs with walking, relieved by rest. History of smoking, diabetes, hypertension, or hyperlipidemia. Possible rest pain in advanced disease.
What are the key physical examination findings in peripheral vascular disease?
Decreased or absent peripheral pulses. Bruits over affected arteries. Signs of chronic limb ischemia: hair loss, shiny skin, ulcerations.
What investigations are necessary for diagnosing peripheral vascular disease?
Ankle-brachial index (ABI) to assess severity of arterial disease. Doppler ultrasound to evaluate blood flow. Angiography in severe cases or for surgical planning.
What are the non-pharmacological management strategies for peripheral vascular disease?
Smoking cessation and regular exercise. Foot care to prevent ulcers and infections. Healthy diet and management of comorbid conditions (diabetes, hypertension).
What are the pharmacological management options for peripheral vascular disease?
Antiplatelet agents (e.g., aspirin, clopidogrel). Statins for lipid control. Cilostazol to improve walking distance. Revascularization procedures (angioplasty, stenting) in severe cases.
What are the red flags to look for in peripheral vascular disease patients?
Critical limb ischemia: rest pain, non-healing ulcers, or gangrene. Sudden onset of severe limb pain suggesting acute arterial occlusion. Signs of systemic infection with limb ischemia.
When should a patient with peripheral vascular disease be referred to a specialist?
Refractory symptoms despite medical treatment. Consideration for surgical or endovascular interventions. Complex cases requiring specialized vascular evaluation.
What is one key piece of pathophysiology related to peripheral vascular disease?
Atherosclerosis leading to narrowing and occlusion of peripheral arteries. Reduced blood flow causes ischemic symptoms in the affected limbs.
