Peripheral Arterial Disease Flashcards
(8 cards)
What symptoms characterize LE PAD?
Pain in legs (calves) with walking, relived by rest, does not notice when standing (would indicate more neurogenic claudication potential)
The pain is constant when occurring (ie: similar everyday), change in day to day quality could point more towards neurogenic.
What percentage of patients over age 75 have significant PAD?
Approximately 20-25% of patients > 75 years old
What is the initial screening for PAD? What could be done after this initial screen?
ABI
Either segmental pressures (peripheral vascular resistance (PVR) studies), or can ABI with exercise (if ABI at rest was negative and clinical suspicion is still high).
What ABI values indicate presence of PAD?
Normal = 0.9-1.0
- 8-0.9 = borderline
- 5-0.8 = abnormal (note: > 1.4 = noncompressible is also abnormal and indicates disease).
< 0.4 == severe
What is the number 1 treatment option shown to improve pain/functionality in the months following diagnosis?
Treatment Exercise Regimen
3 times/week for 30 minutes for 3 months (3 x 3 x 3)
Can be either on own or monitored through exercise program.
What is the reason for Rx ASA or Clopidogrel in a patient with PAD diagnosis?
This is an anginal equivalent, and thus ASA or clopidogrel is given for 2ndary CV prophylaxis to prevent Cardiac events.
Progression of disease in 5 years:
- How many patient go from Asx PAD –> Sx Claudication in 5 years?
- How many patient go fromSx Claudication –> Critical Limb Ischemia in 5 years?
- How many patient go from Sx Claudication –> amputation in 5 years?
- 7-10%
- 10-30%
- 5-25%
What defines critical limb ischemia? How many patients in 1 year after diagnosis of CLI will have both limbs? 1 limb? Death?
CLI –> ABI < 0.4, Toe Pressure < 30 mmHg, diabetic foot ulcer, non-healing lower limb or foot ulcer for more than 2 weeks, gangrene involving the foot or lower limb.
In 1 year post-CLI diagnosis:
- 50% will be alive with both limbs
- 25% will be alive with one limb amputated
- 25% will be dead
