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Peripheral Vascular Disease: Acute Lower Limb Ischaemia (Clinical…
Peripheral Vascular Disease: Acute Lower Limb Ischaemia
Aetiology
Embolic
Cardiac thrombus or cardiac arrhythmias
Secondary to aneurysm thrombus or thrombus on atherosclerotic plaques
Rheumatic fever
Thrombotic
Thrombophilia
Popliteal aneurysms
Malignancy
Chronic atherosclerotic stenosis
Clinical Presentation (5 P's)
Pallor
Paresthesia (abnormal tingling or pricking
Pain --> opioid relief
Paralysis
Perishingly Cold
Other symptoms
Limb is very cold and have marbled appearance
Pulses are diminished
Compartment syndrome (pain in the leg due to compression
Sensation and movement are reduced
Risk Factors
Same as any CV disease
Diagnosis
MRI angiography
CT angiography
Duplex US
Ankle/Brachial Pressure Index: ABPI <0.5 is claudication and is limb ischaemia
Treatment
Depends on the level of severity
Warfarin
Thrombolysis, Embolectomy, Bypass graft and Amputation
Heparin