Peripheral Vascular Disease Flashcards Preview

Cardiovascular Block > Peripheral Vascular Disease > Flashcards

Flashcards in Peripheral Vascular Disease Deck (15):
1

Greatest Atherosclerosis Risk Factors

Diabetes and smoking are greatest risk factors; diabetes is more significant

2

Atherosclerosis Affected Areas

This is a systemic disease because affects all arteries in the body; don’t just focus on the part of the body the patient is complaining about

ATHEROSCLEROSIS: A systemic process affecting all vascular beds and the heart

3

Pseudoclaudication vs. Intermittent Claudication

Pseudoclaudication: neurologic symptoms with it from impingement in spine; pain with standing, and variable onset

Intermittent Claudication: does not occur with standing, location of discomfort varies, onset is the same each time (distance)

4

ABI

ABI = ankle systolic pressure / brachial systolic pressure

The lower the ABI, the higher the chance of death/ lower chance of survival
Super high ABI is abnormal (>1.3)

5

Indication for Cilostazol

Cilostazol is indicated for the reduction of symptoms of intermittent claudication, as indicated by an increased walking distance
Used to tx claudication and nothing else

6

Contraindications to Cilostazol Use

Congestive Heart Failure (CHF) of any severity
Any known or suspected hypersensitivity to any of its components

Cilostazol and several of its metabolites are inhibitors of phosphodiesterase III. Several drugs with this pharmacological effect have caused decreased survival compared to placebo in patients with class III-IV congestive heart failure. PLETAL is contraindicated in patients with congestive heart failure of any severity.

7

Antiplatelet Therapy Use

All patients with peripheral arterial disease should receive antiplatelet therapy unless contraindicated!

8

Acute Arterial Occlusion Ischemic Rest Pain Presentation

Presentation – the 4 “P”s
Pain
Pallor
Pulseless
Paresthesia

9

Fibromuscular Dysplasia (FMD)

Congenital absence of medial layer of artery (muscular layer) which provides structure

Renal - 60 – 75% involved

20 – 50 year old female with HTN

10

Raynaud’s Phenomenon

Triphasic color change
White – cessation of blood flow
Blue – as slow blood flow returns, majority desaturated blood.
Red – digital arteries fully open – reactive hyperemia – throbbing pain.

11

Thromboangiitis ObliteransBuerger’s Disease

Treatment: total abstinence from all forms of tobacco

12

Compartment Syndrome

Clinical situations:

Trauma – fractures
Malfitting bandages or casts
DVT – phlegmasia cerulea dolens
Arterial reperfusion injury – thrombolysis
Arterial sheath hematoma

13

Recurrence of DVT

If patient had provoked DVT (from knee surgery for example) your risk of recurrence in one year is 1% and at 5 years is 3%

If from medical illness it is 5%, and 15%

If unprovoked, they have a higher risk of recurrence is 10% and 30%

Hypercoagulable states during pregnancy, and post birth 2 weeks is the highest risk of DVT

20 - 25% of patients die suddenly of DVT before getting treatment

14

Deep Venous Thrombosis Spectrum: Risk for PE and Post-Thrombotic Syndrome

If DVT in tibial vein: low risk
If DVT in femoral-popliteal vein: medium risk
If DVT in iliofemoral: high risk

15

Iliofemoral DVT Etiology

May-Thurner Syndrome
"iliac vein compression syndrome"
R common iliac artery crosses over L common iliac vein
Chronic compression cause inflammatory syndrome, get dehydrated
Surgical repair