Peripheral vascular disease

Question 1

PVD

Answer 1

Occurs due to atherosclerosis causing stenosis of arteries via a multifactorial process involving modifiable and non-modifiable risk factors.

Question 2

PVD types?

Answer 2

intermittent claudication, critical limb ischaemia, acute limb ischaemia, arterial ulcers, gangrene.

Question 3

PVD intermttent claudication?

Answer 3

caused by narrowing or blockage in femoral artery, due to atherosclerosis.

blood flow in the leg is reduced. Blood circulation is usually sufficient when resting, but when you start walking the calf muscles cannot obtain enough blood. This causes cramp and pain which gets better after resting for a few minutes. If greater demands are made on the muscles, such as walking uphill, the pain comes on more quickly.

Question 4

PVD critical limb ischaemia?

Answer 4

Question 5

PVD acute limb ischaemia?

Answer 5

sudden decrease in arterial perfusion in a limb due to thrombotic or embolic causes

Question 6

PVD risk factors?

Answer 6

smoking, DM, hypertension, hyperlipidaemia, physical inactivity, obesity

Question 7

PVD symptoms of intermittent claudication?

Answer 7

cramping pain in calf after walking.

Question 8

PVD features of critical limb ischaemia?

Answer 8

ulcers, gangrene, rest pain, night pain (often dangle leg)

Question 9

PVD signs?

Answer 9

6Ps, pain, pale, pulseless, paralysis, paraesthesia, perishingly cold.

Also atrophic skin, hairless, punched out skin ulcers, colour change when raising leg.

Question 10

PVD Investigations (8)?

Answer 10

BP,

FBC (anaemia will worsen ischaemia),

fasting blood glucose,

lipid levels,

ECG for pre-existing coronary artery disease,

colour duplex ultrasound (first line to show site and degree of stenosis),

MRI/CT (assesses extent and location)

ABPI (marker of cardiovascular disease).