Peripheral Vascular Disease Flashcards
Define Peripheral Vascular Disease?
Occurs due to atherosclerosis causing stenosis of arteries via a multifactorial process involving modifiable and non-modifiable risk factors
What is the aetiology of Peripheral Vascular Disease?
Occurs due to Atherosclerosis in peripheral arteries
What are the different types of PVD?
Intermittent Claudication Critical Limb Ischaemia Acute Limb Ischaemia Arterial Ulcers Gangrene
What does intermittent claudication present as?
Calf pain on exercise
What are the characteristics of Critical Limb Ischaemia?
Pain at rest
This is the most severe manifestation of Peripheral Vascular Disease
What are the characteristics of Acute Limb Ischaemia?
A sudden decrease in arterial perfusion in a limb, due to thrombotic or embolic causes
What are the risk factors for Peripheral Vascular Disease?
Same as the risk factors for any other atherosclerotic disease: Smoking Diabetes Hypertension Hyperlipidaemia Physical Inactivity Obesity
What is the epidemiology of Peripheral Vascular Disease?
55-70 yrs = 4-12% affected
70+ yrs = 15-20% affecte
More common in males
Incidence increases with age
What are the presenting symptoms of Intermittent Claudication?
Cramping pain in the calf, thigh or buttock after walking for a given distance (claudication distance) and relieved by rest
Calf claudication = femoral disease
Buttock claudication = iliac disease
What are the features of Critical Limb Ischaemia?
Ulcers
Gangrene
Rest pain
Night pain (relieved by dangling leg over the edge of the bed)
What are the presenting symptoms of Leriche Syndrome (aortoiliac occlusive disease)?
Buttock Claudication
Impotence
Absent/weak distal pulses
What is the Fontaine classification of Peripheral Vascular Disease?
Asymptomatic
Intermittent claudication
Rest pain
Ulceration/gangrene
What are the signs of Acute Limb Ischaemia on physical examination?
6 P's Pain Pale Pulseless Paralysis Paraesthesia Perishingly Cold
What are the other symptoms of Peripheral Vascular Disease on physical examination?
Atrophic skin
Hairless
Punched-out ulcers (often painful)
Colour change when raising leg (to Buerger’s Angle)
What investigations for Peripheral Vascular Disease?
Full Cardiovascular Risk Assessment
Colour Duplex Ultrasound
MRI/CT
ABPI (Ankle-Brachial Pressure Index)
