Peripheral vascular disease Flashcards
1
Q
What is the definition of peripheral vascular disease?
A
Chronic narrowing of arteries distil to the arch of the aorta
2
Q
How common is peripheral vascular disease?
A
Affects 4-12% of people aged 55-70
3
Q
What is the pathology of peripheral vascular disease?
A
- Narrowing most often due to atherosclerosis
- Acute limb ischemia = sudden ↓ in arterial perfusion in the limb due to thrombus/emboli
- Subclavian and brachiocephalic trunk is the most common location for atherosclerotic lesions
4
Q
What are the risk factors/aetiology of PVD?
A
- Smoking
- Diabetes
- Hypertension
- Hyperlipidaemia
- Physical inactivity
- Obesity
5
Q
What are the signs/symptoms of PVD?
A
- Intermittent claudication
- Skin ulceration
- Arterial
- On toes, foot and heal
- Painful
- Punched out edges, well demarcated
- Surrounding area pale
- Non granulating
- Necrotic
- Gangenere
- Male impotence
- Loss of hair
- Skin changes
- Poor wound healing
- Resting limb pain = critical limb ischemia
- Relieved at night by hanging the foot out of the bed
- Paralysis
- Pulseless
- Pale
- Paraesthesia
- Perishingly cold
- Unequal arm pressure – common in subclavian arterial occlusion (difference of 15mm/Hg or more)
6
Q
What diseases present similarly to PVD?
A
- Sciatica
- Spinal stenosis
- DVT
- Muscle/tendon injury
7
Q
What investigations are conducted for suspected PVD?
A
- Blood pressure
- FBC, ESR, thrombophilia screening
- Fasting blood glucose
- Lipid levels
- ECG
- Doppler ultrasonography
- CT/MR angiography
8
Q
What are the surgical treatments for PVD?
A
• Endovascular stenting/angioplasty/bypass
9
Q
What are the pharmacological treatments for PVD?
A
- Statins
- Antihypertensives – ACE inhibitors
- Antiplatelets
- Peripheral vasodilators e.g. naftidrofuryl
10
Q
What are the non pharmacological treatments for PVD?
A
- Smoking cessation
- Regular exercise
- Weight reduction
