Peripheral Vascular Disease Flashcards
What are the 3 main patterns of presentation that may be seen in patients with PAD?
1) intermittent claudication
2) critical limb ischaemia
3) acute limb-threatening ischaemia
What characterises intermittent claudication?
Pain or discomfort in the legs during physical activity that subsides with rest.
Cause of intermittent claudication?
Due to reduced blood flow to the muscles due to narrowing or blockage of the arteries.
Where is pain typically located in intermittent claudication?
- calf muscles (most common)
- also possibly thighs, buttocks or feet
Assessment in PAD?
1) check the femoral, popliteal, posterior tibialis and dorsalis pedis pulses
2) check ABPI
3) duplex US (1st line)
4) magnetic resonance angiography (MRA) should be performed prior to any intervention
Interpretation of ABPI:
a) 1
b) 0.6-0.9
c) 0.3-0.6
d) <0.3
a) normal
b) claudication
c) rest pain
d) impending
What is PAD strongly linked to?
Smoking
What medication should any patient with PAD be taking?
Statin (80mg)
What antiplatelet should be used 1st line in patients with PAD?
Clopidogrel (in preference to aspirin)
What is the most severe form of PAD?
Critical limb ischaemia
What is critical limb ischaemia characterised by?
1) chronic ischaemic rest pain
2) non healing wounds
3) gangrene
What is acute limb-threatening ischaemia?
a severe manifestation of PAD that requires urgent medical attention
What characterises acute limb-threatening ischaemia?
1 or more of the 6 P’s:
1) sudden onset pain
2) pallor
3) pulselessness
4) paralysis
5) paraesthesia
6) ‘perishingly col’
Mx of acute limb-threatening ischaemia?
Revascularisation procedures such as thrombolysis, angioplasty, or surgical bypass.
What 2 medications should all patients with PAD take?
1) clopidogrel
2) atorvastatin
