Peripheral Vascular Disease CAT

Question 1

What is PVD?

Answer 1

• Narrowing of blood vessels, which reduces bloodflow
• Usually secondary to atherosclerosis

Question 2

What is the ultimate culmination of the atherosclerotic process?

Answer 2

Significant or complete occlusion of medium and large arteries

Question 3

Primary risk factor for PVD

Answer 3

Atherosclerosis

Question 4

Other risk factors for PVD

Answer 4

• Phlebitis
• Injury or surgery
• Autoimmune disease
• Diabetes mellitus
• Smoking
• Hyperlipidemia
• Inactivity
• Hypertension
• Positive family history
• Increased age
• Obesity

Question 5

Clinical presentation for PVD

Answer 5

Early stages
- Intermittent claudication (symptom onset after walking a certain distance, relieved by rest; LEs buckling after exertion)
Later/advanced stages
- N/T in affected extremities
- Pain at rest/during sleep
- Slowed healing
- Changes in skin color
- Decrease in skin temp
- Absence of hair on one extremity
- Weak/absent pulse

Question 6

Labs or imaging w/ PVD

Answer 6

• Blood tests
• Ultrasound for flow status
• ABI

Question 7

ABI

Answer 7

Ratio of SBP of LE/UE

Question 8

Other tests for PVD

Answer 8

• Rubor of dependency
• Transcutaneous oximetry
• Treadmill exercise tests

Question 9

Pharmacological management of PVD

Answer 9

• Anticoagulants (i.e. heparin)
• Antiplatelet agents
• Thrombolytics

Question 10

Physical therapy for PVD

Answer 10

• Walking program initially (walk until symptom onset, rest and repeat; goal is to increase duration of walking)
• Non-WB exercises
• Resistance exercises introduced after 4-6 weeks