Peripheral vascular disease Flashcards
What causes peripheral vascular disease?
atherosclerosis causing stenosis of the arteries
Chief feature of PAD?
intermittent claudication
What is intermittent claudication?
pain/cramping within the calf, thigh or buttock after walking a short distance
If claudication pain occurs at rest and is relieved by hanging legs over the side of the bed, what is the most likely diagnosis?
critical limb ischaemia
Claudication within the calf suggest disease within which artery?
femoral
Claudication within the buttock suggests disease within which arteries?
iliac
Other signs of critical limb ischaemia
ulceration and gangrene
Signs of peripheral arterial disease?
absent pulses; cold, white legs; atrophic skin; punched out ulcers; postural dependent colour change; cap refill of >5 secs
Tests for peripheral arterial disease?
ABPI - 1-1.2 normal; 0.5-0.9 is ischaemic; ,0.5 is severely ischaemic; Doppler imaging; CT angiography
4 stages of PAD
1 - asymptomatic, 2 - intermittent claudication, 3 - ischaemic pain at rest, 4 - ulceration/gangrene
Intervention for intermittent and aysmptomatic claudication
quit smoking, increase exercise - supervised, vasoactive drugs, anti-platelet drugs (i.e. clopidogrel)
Intervention for more severe and limb-threatening PAD
percutaneous transluminal angioplasty, surgical reconstruction, amputation
6 Ps of acute limb ischaemia
pale, pulseless, painful, paralysed, paraesthetic (pins and needles), perishingly cold
Onset of fixed mottling in acute limb ischaemia implies?
irreversibility
Acute limb ischaemia requires treatment within…
4-6 hours
