Vascular Disease

Question 1

Peripheral Vascular disease

Answer 1

Peripheral vascular disease can be either be:

OCCLUSIVE (e.g. intermittent claudication: Cramping leg pain is induced by exercise due to obstruction in the arteries which restricts blood flow to legs.) in which occlusion of the arteries is caused by atherosclerosis

OR

VASOSPASTIC (e.g. Raynaud’s syndrome: Spasms of arteries in the
Extremities).

Question 2

Peripheral arterial occlusive disease is associated with

Answer 2

an increased risk of cardiovascular events. The risk is reduced by smoking cessation, controlling blood pressure, regulating blood lipids, optimising glycaemic control in diabetes, taking aspirin at a dose of 75mg and reducing weight in obesity

Question 3

Peripheral Vascular disease treatment

Answer 3

• Naftidrofuryl oxalate can alleviate symptoms of intermittent claudication and improve pain-free walking distance.
• Cilostazol can be used for intermittent claudication to improve walking distance in patients who do not have pain at rest. It is used 2nd line when lifestyle interventions have failed to control symptoms.
• Management of Raynaud’s syndrome includes avoidance of exposure to cold and stopping smoking. More severe symptoms may require vasodilator treatment, which is often successful.
• Nifedipine is used for reducing the frequency and severity of vasospastic attacks. Alternatively, Naftidrofuryl oxalate may produce symptomatic improvement.

Question 4

Occlusive treatment:

Answer 4

Aspirin 75mg daily and statin as secondary prevention of CVD events

Question 5

Vasospastic treatment

Answer 5

Stop smoking and avoid excess exposure to cold. Nifedipine can be used.