Peripheral Vascular Disease Flashcards
What does peripheral arterial disease refer to?
Narrowing of the arteries supplying the limbs and periphery, reducing blood supply.
What is intermittent claudication?
Symptom of ischaemia in a limb that occurs during exertion and is relieved by rest.
What are the characteristics of chronic limb-threatening ischaemia?
- Pain at rest
- Burning pain worst at night
- Non-healing ulcers
- Gangrene
What is acute limb ischaemia?
Rapid onset of ischaemia in a limb, typically due to a thrombus blocking arterial supply.
Define ischaemia.
Inadequate oxygen supply to tissue due to reduced blood supply.
What does necrosis refer to?
Death of tissue.
What is gangrene?
Death of tissue specifically due to an inadequate blood supply.
What does atherosclerosis refer to?
Combination of atheromas (fatty deposits) and sclerosis (hardening of blood vessel wall).
What are the effects of atheromatous plaques?
- Stiffening of artery walls
- Stenosis leading to reduced blood flow
- Plaque rupture causing thrombus and ischaemia
List the non-modifiable risk factors for atherosclerosis.
- Older age
- Family history
- Male
List the modifiable risk factors for atherosclerosis.
- Smoking
- Alcohol
- Poor diet
- Low exercise/sedentary lifestyle
- Obesity
- Poor sleep
- Stress
What medical co-morbidities are associated with atherosclerosis?
- Diabetes
- Hypertension
- Chronic kidney disease
What are the end results of atherosclerosis?
- Angina
- Myocardial Infarction (MI)
- Transient Ischaemic Attack (TIA)
- Stroke
- Peripheral arterial disease
- Chronic mesenteric ischaemia
What are the clinical features of acute limb ischaemia known as the 6 P’s?
- Pain
- Pallor
- Pulseless
- Paralysis
- Paraesthesia
- Perishingly cold
What is Leriche syndrome?
Occurs with occlusion of distal aorta or proximal common iliac artery, presenting with thigh/buttock claudication, absent femoral pulses, and male impotence.
What are the signs of peripheral arterial disease on examination?
- Skin pallor
- Cyanosis
- Dependent rubor
- Muscle wasting
- Hair loss
- Ulcers
- Poor wound healing
- Gangrene
What does the Buerger’s test assess?
Assessment for PAD in the leg.
Fill in the blank: Arterial ulcers are caused by ischaemia secondary to inadequate blood supply and have a _______ appearance.
punched-out
What is the ankle-brachial pressure index (ABPI)?
Ratio of systolic BP in ankle compared with arm.
What does an ABPI of <0.9 indicate?
Peripheral arterial disease (PAD).
What are the management options for intermittent claudication?
- Lifestyle changes
- Exercise training
- Medical treatments
- Surgery
What urgent actions should be taken for critical limb ischaemia?
- Urgent vascular referral
- Analgesia for pain
- Urgent revascularisation
What is the primary treatment for acute limb ischaemia?
- Urgent referral to on-call vascular
- Endovascular thrombolysis
- Endovascular thrombectomy
- Surgical thrombectomy
