Peripheral Vascular Disease Flashcards
describe damage to artery wall in peripheral vascular damage
endothelial cell damage
can e due to cigarette smoke, increased BP, increased glucose, increased chlesteol, increased homocysteine and increased free radicals
describe formation of plaque
activated platelets
LDL cholesterol - oxidised
inflammatory response - macrophages turn into foam cells
describe intermittent claudication
occurs when insufficient blood reaches exercising muscles
patient is pain free at rest but after variable periods of exercise develops ischaemic pain in the affected limn, which is further relieved by further rest
who is most affected by intermittent claudication and critical limb ischaemia
males
>55 years
risk factors of intermittent claudication and critical limb ischaemia
smoking!!!
hypertension
diabetes
raised cholesterol
pathology of intermittent claudication and critical limb ischaemia
atherosclerosis (elsewhere in body and associated with large cardiovascular morbidity and mortality)
symptoms of intermittent claudication and critical limb ischaemia
pain with exercise
rest pain/tissue loss
worse at night
tests for investigating intermittent claudication and critical limb ischaemia
ABPI (ankle-brachial pressure index) - low BP in leg => peripheral vascular disease
duplex ultrasound
angiography (MRI, catheter, CT)
treatment of intermittent claudication and critical limb ischaemia
risk reduction - smoking, lipid lowering, antiplatelets, hypertenison, diabetes
angioplasty, surgery
amputation
normal ranges for ABPI
0.9-1.2
claudication 0.4-0.85
sevee - 0-0.4
signs of intermittent claudication and critical limb ischaemia
cool to touch absence of peripheral pulse colour change poor tissue nutrition - hairless, thick nails, shiny skin venous guttering ulcers gangrene
