PVD Flashcards
MCC of PVD
Atherosclerosis most common cause
Coronary dz is present in what percentage of people with atherosclerosis
Coronary disease present in >50%
mortality with PAD
Mortality 2-3x greater vs general population
Prevalence of CAD with age
3% (40-59 years)
8% (60-69 years)
19% (>70 years)
commone sxs of PAD
pain with walking + missing pulse
=PAD
Venous reflux disease is__-more prevalent than coronary heart disease (CHD) and ___ more prevalent than peripheral arterial disease (PAD)1
Venous reflux disease is 2x more prevalent than coronary heart disease (CHD) and 5x more prevalent than peripheral arterial disease (PAD)1
PAD is more commonly see in what population
older people and women
what percentage of people with sx reflux seek tx?
Statistics show that of the 25 million people in the U.S. who suffer from symptomatic reflux, only about 5% seek treatment annually; 2/3 of patients who do seek treatment have saphenous reflux
PAD is usually due to
astheroclerotic dz that leads to narrowing
where do you see astherosclerosis
horrible inflammatory process of arterial wall not usually seen in aprta
Venous insufficiency is the result of _____ of the venous vessels in the legs.
Venous insufficiency is the result of over-dilation of the venous vessels in the legs.
how to assess if venous reflux is prescent
To assess if venous reflux is present, a duplex ultrasound scan is performed
risk factors for PAD
Diabetes Smoking History of CAD Elevated cholesterol or decreased HDL Hypertension Sedentary lifestyle Obesity Male gender Age
Risk factors of venous insufficiency:
Gender
Age
Heredity
Pregnancy
Standing occupation
Obesity
Prior injury or surgery
Sedentary lifestyle
Approximately ___ as many women as men are affected by varicose veins, suggesting that female hormones may be a risk factor
Gender: Approximately four times as many women as men are affected by varicose veins, suggesting that female hormones may be a risk factor
Symptoms of venous insufficiency
Leg pain, aching, or cramping
Burning or itching of the skin
Leg or ankle swelling
“Heavy” feeling in legs
Skin discoloration or texture changes
Open wounds or sores
Restless legs
Varicose Veins
Pain in calf with walking that resolves with rest
: Claudication
common Hx in pt with PAD
pain in calf with walking that resolves with rest: Claudication
Area of pain can suggest level of dz.
Differentiate from pseudo claudication
Pain at rest in the affected extremity
Sores or ulcers that do not heal
Non-specific leg heaviness and fatigue
Pain and itching in varicose veins
Atypical Sx of PAD
” Pain in the ankle with walking
“ Rest pain may manifest in one toe
Fatigue in calf while walking
“
DM that smoke % chance of PAD
29%
PE
Skin color, hair loss, skin necrosis or ulceration, edema or bulging veins or asymmetry
hallmarks of venous ulcers
wet
and often painless
aterial ulcers are often very painful
where should you listen when evaluating a pt with suspected arterial dz
” Listen over the carotids and femorals for bruits
Abdominal bruits may indicate renal or mesenteric vascular stenosis
Cardiac auscultation: Valvular stenosis or regurgitation; unlikely to hear vascular bruits.
Aortic stenosis can radiate to carotids
what would you suspect in an older and younger person with different blood pressures on each arm
older person =subclavian artery stenosis
younger person= coarctation of the aorta
