PAD Flashcards
peripheral arterial disease
narrowing of arteries supplying limbs and periphery - reducing blood supply to these areas
intermittent claudication
symptom of ischaemia in limb
occurs on exertion, relieved by rest
crampy, achy pain
critical limb ischaemia
end-stage of PAD , inadequate blood supply to a limb meaning it cannot function properly at rest
pain at rest, non-healing ulcers, gangrene
risk losing limb
acute limb ischaemia
rapid onset of ishcaemia
typically due to thrombus blocking blood supply
atherosclerotic plaques cause…
- stiffening of artery walls –> htn and strain on heart
- stenosis –> reduced blood flow
- plaque rupture –> thrombus
atherosclerosis risk factors: non-modifiable
older age
FHx
age
atherosclerosis risk factors: modifiable
smoking alcohol poor diet sedentary poor sleep stress
medical co-morbidities increasing risk of atherosclerosis
diabetes htn CKD inflammatory conditions e.g. RA atypical antipsychotics
how does PAD present
with intermittent claudication
- crampy pain
- after walking certain distance
- releived by rest
- often calves
features of critical limb ischaemia
pain pallor pulseless paralysis paraesthesia perishing cold
critical limb ischaemia pain characteristics
burinig pain, worrse at night when leg raised (gravity no longer helps pull blood to foot)
Leriche syndrome
with occlusion in distal aorta or proximal common iliac artery
Leriche syndrome clinical triad
thigh/buttock claudication
absent femoral pulses
male impotence
examination signs
tar staining xanthomata weak peripheral pulses skin pallor cyanosis hair loss ulcers reduced temp reduced sensation prolonged CRT
Beurger’s test
- pt supine, lift up legs and look at colour (pallor)
2. sit them up w legs haging over side bed. obervse colout (blue to rubor)
