Vascular Flashcards
Define peripheral arterial disease
Narrowing of the arteries supplying the peripheries
Define intermittent claudication
A symptom of ischaemia in a limb, occuring during exertion and relieved by rest. Typically crampy, achy pain in calf thigh or buttock associated with waliing a certain distance.
Define critical limb ischaemia
End stage of peripheral arterial disease, where there is inadequate blood supply to a limb to allow it to function normally at rest.
Define acute limb ischaemia
Refers to rapid onset of ischaemia in a limb, typically due to a thrombus
Risk factors for atherosclerosis
Old age
FH
Male
Smoking
Alcohol
Poor diet - high sugar and fat
Low exercise
Obesity
Poor sleep
Stress
Diabetes
HTN
CKD
Inflammatory conditions - arthrits
Atypical antipsychotics
Clinical features of critical limb ischaemia
6 P’s
Pain
Pallor
Pulseless
Paralysis
Paraesthesia - pins and needles
Perishing cold
Features of arterial ulcers
Caused by ischaemia
Smaller and deeper than venous
Well defined borders
Punched out appearance
Occur peripherally - on toes
Reduced bleeding
Painful
Features of venous ulcers
Caused by pooling of blood
Are larger and more superficial than arterial
Occur after minor injury to leg
Irregular gently sloping borders
Less painful
Signs of chronic venous insufficiency 0 haemosidering, venous eczema
Investigations in peripheral arterial disease
ABPI
Duplex ultrasound - volume of blood flow
Angiography
Management of peripheral arterial disease
Lifestyle - exercise!
Statins
Clopidogrel
Surgery - angioplasty, endarterectomy, bypass
Management of critical limb ischaemia
Urgent revascularisation
?amputation
Define DVT
A thrombus that develops in the deep vascular system.
Risk factors for DVT
Immobility
Recent surgery
Long haul travel
Pregnancy
HRT - with oestrogen!
Malignancy
Polycythaemia
SLE
Thrombophilia
Examples of thrombophilias
Antiphospholipid syndrome
Factor V Leiden
Antithrombin deficiency
Protein C or S deficiency
Prothrombin gene variant
Activated protein C resistance
History of DVT
Calf/leg swelling >3cm
Dilated superficial veins
Tenderness in calf
Oedema
Colour changes
What scoring system is used in DVT
Wells score
Define varicose veins
Distended superficial veins measuring more the 3mm in diameter, usually affecting the legs
Risk factors for varicose veins
Old age
FH
Female
Pregnancy
Obesity
Prolonged standing
DVT
History of varicose veins
Asymptomatic
Heavy dragging sensation in legs
Aching
Itching
Burning
Oedema
Muscle cramps
Restless legs
Management of varicose veins
Weight loss
Exercise
Elevate legs
Compression stocking
Surgery - endothermal ablation, sclerotherapy
Define chronic venous insufficiency
Occurs when blood does not drain efficiently from the legs to the heart. This often leeds to chronic pooling of blood in the legs.
Management of chronic venous insufficiency
Skin hygiene
Weight loss exercise
Elevate legs
Compression stocking
Define lymphoedema
Chronic condition caused by impaired lymphatic drainage of an area, tissues in this area become swollen with excess fluid.
Management of lymphoedema
Massage techniques to drain
Compression
Weight loss
Skin care
