Peripheral Vascular Disease and Varicose Veins Flashcards
What are the risks for venous insufficiency?
Increased Abdominal pressure/obstruction leading to valve failure: Ascites Weight Pregnancy Pelvic Tumours
Valve Failure Increased pumping (calves in athletes), straining
What are the most common sites for atherosclerosis (to cause PVD)
Superficial Femoral Artery
What are the symptoms of Leriche’s?
Bilateral Buttock/Thigh Pain
Erectile Dysfunction
Where is the problem in Leriche’s?
Bifurcation of the aorta
What is Peripheral Vascular Disease?
Chronic Limb Ischaemia
Restriction of blood flow to a limb causing pain distally, for at least 2 weeks
Symptoms of Intermittant Claudication?
Pain on movement/exercise
Relieved at rest
Distal to proximal (normally calves)
Symptoms of Ischaemic Rest Pain?
Pain at rest
Worse at night/in bed
Have to dangle foot out of bed
What are varicose veins?
Abnormal, dilated, tortuous superficial veins which usually occur due to increased flow from the Deep veins which have failed somehow
What are the features of venous insufficiency?
Varicose Veins Varicose Eczema Thrombophlebitis Atrophy Blanche Lipodermatosclerosis
Investigations in Varicose Veins?
Trendelenbergs
What are the features of venous insufficiency?
Varicose Veins Varicose Eczema Thrombophlebitis Atrophy Blanche Lipodermatosclerosis Ulcers
Investigations in Varicose Veins?
Trendelenbergs
Tap Test
Cough Test
Investigations in PVD
Bloods - Cholesterol, Clotting, Glucose Treadmill Test - Do ABPI before and after (returns to normal slower) Buergers Test Duplex Scan/Doppler CT Angiogram ABPI
Treating PVD
Conservative: Weight loss, diet, exercise, education
Medical: statins, anti-hypertensives, anti-platelets, diabetes treatment
Surgical: PCI (if one) or bypass (multiple)
Amputation
Why do people get Intermittant Claudication
Increased O2 requirement
Arteries cannot supply enough
Anaerobic Metabolism
Substance P and lactate formed creating cramping pain
