Please enable JavaScript.
Coggle requires JavaScript to display documents.
Peripheral Vascular Disease (Risk Factors (Hypercholesterolaemia,…
Peripheral Vascular Disease
Epidemiology
Commonly caused by atherosclerosis and usually affects the aorta-iliac and infra-inguinal arteries
More common in men than women
Partial blockage of leg or peripheral vessel by an atherosclerotic plaque and/or resulting thrombi, resulting in insufficient perfusion of the lower limb resulting in LOWER LIMB ISCHAEMIA
Risk Factors
Hypercholesterolaemia
Hypertension
Diabetes
Physical inactivity
Smoking
Obesity
General Symptoms
Absent femoral, popliteal or foot pulses
Cold, white legs
Differential Diagnosis
Osteoarthritis of hip/knee due to knee pain at rest
Peripheral neuropathy - associated with tingling
Diagnosis
ECG to look for cardia ischaemia
Severity of disease is indicated by the ankle/brachial pressure index
FBC - haemoglobin would exclude anaemia or polycthaemia
Exclude arteritis by looking at ESR/CRP (they would be raised)
Colour duplex - ultrasound
MRI/CT angiography to assess extent and location of stenoses and quality of distal vessels
Critical Ischaemia
There is no reserve available for the increased demand
There is resting pain - typically NOCTURNAL
Blood supply is inadequate to allow basal metabolism
Gangrene/infection risk
Tissue is DYING and SUFFERING AT REST
Intermittent Claudication
Tissue is NOT DYING just suffering
When doing mild/moderate exercise, you have an oxygen debt resulting in a build up of lactic acid resulting in pain
It is ischaemic leg pain
In a claudicated patient the physiological pain is 'standard'
Treatment
Revascularisation for critical ischaemia
SURGICAL EMERGENCY when acute ischaemia
Risk factor modification - smoking cessation, treat hypertension/hyperlipidaemia/diabetes, antiplatelet agent & exercise + weight loss