Peripheral vascular disease Flashcards
atherosclerosis risk factors
older age, FH, male
smoking, poor diet, obesity
diabetes, low exercise
peripheral arterial disease
atherosclerosis and narrowing of arteries supplying limbs and periphery
critical limb ischaemia
end stage peripheral arterial disease
inadequate supply of blood to limb to allow it to function at rest
intermittent claudication
ischaemia in a limb during exertion
crampy, achy pain in calf
relieved by rest
clinical triad of Leriche’s syndrome
thigh/buttock claudication
absent femoral pulses
male impotence
what causes Leriche’s syndrome?
occlusion in distal aorta or proximal common iliac artery
pulses - name them
radial brachial carotid femoral popliteal dorsalis pedis posterior tibial aorta
examination findings
weak peripheral pulses
pallor, cold, skin changes - ulceration, hair loss
buergers test
what can be used to more accurately assess pulses?
handheld doppler
investigation
ABPI
arterial doppler
angiography
ABPI
ratio of systolic bp in ankle vs arm
ABPI results and what is normal
> 0.9 normal
- 6 = mild disease
- 3 = moderate to severe
6 Ps of critical limb ischaemia
pain pallor paraesthesia perishingly cold pulseless paralysis
non pharm treatment claudication
diet, smoking, exercise
optomise bp, diabetes
medical treatment claudication
atorvostatin 80mg
clopidogrel 75mg
naftidrofuryl oxalate
naftidrofuryl oxalate
peripheral vasodilator
surgicla treatment claudication
percutaneous transluminal angioplasty and stenting
bypass surgery
managing critical limb ischaemia
urgent vascular referral
analgesia
angioplasty and stent
bypass surgery
cardinal features of critical limb ischaemia
ulceration, gangrene, foot pain at rest
Fontaine classification
1 - asymptomatic
2 - intermittent claudication
3- ischaemic rest pain
4 - ulceration/gangrene - critical ischaemia
buergers test
angle 20 degrees
leg goes pale when raised off couch
