peripheral vascular disease Flashcards
(13 cards)
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
