peripheral vascular disease Flashcards
what is Peripheral Vascular Disease
Characterised by narrowing, and in final stages occlusion, of peripheral arteries (arteries OTHER THAN heart or brain) due to atherosclerotic plaques; most commonly affects the legs
cause of peripheral vascular disease
Atherosclerosis
risk factors of peripheral vascular disease
smoking, diabetes, hypercolesterolaemia and hypertension
what is the clinical presentation
- Intermittent claudication
- Severe PVD/ critical limb ischaemia
what is Intermittent claudication
Insufficient blood delivery to exercising muscle due to atherosclerosis in arteries
- Occurs when O2 demand greater than supply
what is Severe PVD/ critical limb ischaemia
- Chronic disease, affects multiple arteries
- Obstruction to blood flow in artery is compromised to the point where blood is unable to maintain oxygenation of the tissue at rest
- Needs urgent attention
Classic presentation of Intermittent claudication
- exertional discomfort (calves) - relieved by rest
Clinical features of Severe PVD/ critical limb ischaemia
- pain at rest
- ulceration
- tissue necrosis
- diminished/absent peripheral pulses and poor tissue nutrition (lack of hair, thick nails, shiny skin)
what is ABPI: Ankle-Brachial pulse index
- Measures ratio of systolic BP in ankle:upper arm
- diabetes can cause falsely high reading; doppler test is taken ct
- Normal: 0.9 - 1.2
- Claudication: 0.4 - 0.85
- Severe claudication: 0 - 0.4
what management should be done regarding lifestyle
SMOKING CESSATION, supervised exercise program, weight loss
- helps collateral vascularisation
management regarding risk factors
diabetes, hypertension
- Antiplatlet: asprin or clopridogel
- Lipid lowering: statins
Revascularisation
- Angioplasty or bypass graft in patients with very severe symptoms or if tissue damage present
- Severe critical limb ischaemia amputation
