peripheral vascular disease

Question 1

what is Peripheral Vascular Disease

Answer 1

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

Question 2

cause of peripheral vascular disease

Answer 2

Atherosclerosis

Question 3

risk factors of peripheral vascular disease

Answer 3

smoking, diabetes, hypercolesterolaemia and hypertension

Question 4

what is the clinical presentation

Answer 4

• Intermittent claudication
• Severe PVD/ critical limb ischaemia

Question 5

what is Intermittent claudication

Answer 5

Insufficient blood delivery to exercising muscle due to atherosclerosis in arteries
- Occurs when O2 demand greater than supply

Question 6

what is Severe PVD/ critical limb ischaemia

Answer 6

• 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

Question 7

Classic presentation of Intermittent claudication

Answer 7

• exertional discomfort (calves) - relieved by rest

Question 8

Clinical features of Severe PVD/ critical limb ischaemia

Answer 8

• pain at rest
  
  • ulceration
  • tissue necrosis
  • diminished/absent peripheral pulses and poor tissue nutrition (lack of hair, thick nails, shiny skin)

Question 10

what is ABPI: Ankle-Brachial pulse index

Answer 10

• 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

Question 11

what management should be done regarding lifestyle

Answer 11

SMOKING CESSATION, supervised exercise program, weight loss
- helps collateral vascularisation

Question 12

management regarding risk factors

Answer 12

diabetes, hypertension
- Antiplatlet: asprin or clopridogel
- Lipid lowering: statins

Question 13

Revascularisation

Answer 13

• Angioplasty or bypass graft in patients with very severe symptoms or if tissue damage present
• Severe critical limb ischaemia amputation