Peripheral Vascular Disease Lecture Powerpoint Flashcards
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Peripheral arterial disease
Atherosclerosis of blood vessels other than the coronary or cerebral arteries leading to obstruction
Atypical leg pain
Lower extremity discomfort that is exertional but does not consistently resolve with rest or consistently limit exercise at a reproducible distance making it different from intermittent claudication but still a finding in peripheral arterial disease
Intermittent claudication
Reproducible discomfort of a defined group of muscle that is induced by exercise and relieved upon rest, classic finding of peripheral arterial disease
Critical limb ischemia
Ischemic rest pain, a non healing wound, or gangrene due to progression from claudication resulting in severe peripheral arterial disease
The 5 P’s of acute limb ischemia that indicate severe peripheral arterial disease
Pain Pulseless Pallor Paresthesias Paralysis Poikilothermia (the rare 6th P)
Ankle brachial index and value ranges
- Division of the lower extremity systolic pressure by the brachial artery systolic pressure to determine if there is arterial disease causing claudication to the lower extremity
- value of 1 is normal and values less than .8 indicate moderate to severe arterial disease
Absent femoral pulses can indicate ___ disease (peripheral arterial disease)
iliac artery
Gradation of pulse intensity on physical exam
0 - absent 1 - diminished 2 - normal 3 - strong 4 - bounding
Some common differential diagnoses of peripheral arterial disease (3)
- degenerative joint disease
- venous insufficiency
- chronic compartment syndrome
Gold standard diagnostic for evaluation of peripheral arterial disease
Peripheral angiography
Treatment of peripheral arterial disease (6)
- Statin
- Antihypertensives
- Aspirin or plavix (antiplatelet therapy)
- Pletal (effective at improving symptoms and increasing walking distance in patients with PAD and claudication)
- revascularization
- amputation
Revascularization therapy
Indicated treatment in patients with significant or disabling symptoms unresponsive to lifestyle adjustment or medical therapy or in patients with limb threatening ischemia to establish arterial blood flow either by angioplasty (bipass), or stenting
Superficial varicosities
A very common form of peripheral venous disease that is due to inadequate muscle pump function, incompetent venous valves, or venous thrombosis and obstruction
Peripheral venous disease presentation vs peripheral arterial disease
- Venous has leg swelling and aching
- Arterial has sharp intermittent pain
Treatment of peripheral venous disease (2)
- leg elevation and compression socks
- surgical excision
