Peripheral Vascular Disease I - Intermittent claudication & critical limb ischaemia Flashcards Preview

Cardiovascular (Annie) > Peripheral Vascular Disease I - Intermittent claudication & critical limb ischaemia > Flashcards

Flashcards in Peripheral Vascular Disease I - Intermittent claudication & critical limb ischaemia Deck (27)
Loading flashcards...
1
Q

what is intermittent claudication?

A

occurs when insufficient blood blood reaches exercising muscle.

2
Q

in intermittent claudication, when does the pain go away?

A

pain free at rest

3
Q

what is another term to describe claudication?

A

muscle ischaemia ON EXERCISE (oxygen demand on exercise)

4
Q

who is at the greatest risk for developing intermittent claudication?

What is the pathology of limb iscahemia?

A
  • male gender
  • age (per 10 years) >55years
  • diabetes
  • smoking
  • hypertension
  • hypercholesterolemia
  • fibrinogen
  • alcohol

atherosclerosis

5
Q

what are 2 non-invasive investigations that can investigate lower-limb ischaemia?

A

1) measurement of ABPI

2) duplex ultrasound scanning

6
Q

what are 3 invasive investigations that can investigate lower limb ischaemia?

A

1) magnetic resonance angiography
2) CT angiography
3) catheter angiography

7
Q

how are you able to quantify the pressure in the leg?

A

ankle brachial pressure index (ABPI)
- listen to posterior tibial pulses and brachial pulse and you take a ratio

ABPI = Ankle pressure / brachial pressure

8
Q

what should the normal ABPI be?
what is the ABPI if there is claudication?
what is the ABPI if it severe?

A

Normal = 0.9-1.2

Claudication = 0.4-0.85

Severe = 0-0.4

9
Q

what does duplex ultrasound scanning do?

A

uses sound waves that bounce off blood vessels to create pictures

10
Q

what is MRA (Magnetic resonance angiography)?

A

techniques based on magnetic resonance imaging to image blood vessels.
= it takes pictures of the inside of your body

11
Q

what is CT angiography?

What is catheter angiography?

A

= visualizes arterial and venous vessels throughout the body. Using contrast injected into the blood vessels

= catheter is inserted into an artery through a small incision. Once the catheter is guided to the area, a contrast material is injected through the tube and images are captured using a small dose of ionizing radiation

12
Q

how can you treat lower limb ischaemia?

A

= guardian therapy (slow it down)

  • smoking
  • lipid lowering
  • anti-platelets
  • hypertension
  • diabetes
  • life style issues
13
Q

in lower limb ishaemia, how can you improve claudication symptoms?

A
  • realistic expectations
  • consent
  • exercise training
  • drugs
  • angioplasty/stenting
  • surgery
14
Q

what is the ideal exercise target that should be done in a week?

A

30mins, 3 times a week for minimum of 6months

15
Q

Yes or No.

Should you push yours when exercising to beyond pain?

A

yes - as only then will you feel the benefits

16
Q

what drug is used to treat lower limb ischaemia?

A

cilostozol

17
Q

how can you treat an angioplasty?

A

insertion of a stent

18
Q

what are the 2 surgical options?

A

1) inflow bypass

2) outflow bypass

19
Q

what should you use in a bypass surgery to reduce the chance of infection?

A
  • your own veins rather than a prosthetic device
20
Q

what should you use in a bypass surgery to reduce the chance of infection?

A
  • your own veins rather than a prosthetic device
21
Q

what are the symptoms of critical limb iscahemia?

A

1) pain at rest = toe/foot ischaemia (nerve ending pan)
- lying/sleeping

2) ulcers/gangrene
= severe iscahemia + damage
- trauma
- footwear

3) toes and forefoot
4) strong analgesia

22
Q

when is critical limb ichaemia worst?

A

at night

23
Q

how is critical limb iscahemia helped?

A

by sitting and putting leg in a dependent position, and by getting up and walking about

24
Q

what is a risk of critic limb iapchaemia?

A

amputation

25
Q

what are the risk factors for critical limb ischaemia?

A

1) smoking

2) diabetes

26
Q

how do you treat critical limb ischaemia?

A
  • realistic expectations
  • analgesia
  • angioplasty/stenting
  • surgical
  • reconstruction/amputation
27
Q

what is angioplasty?

A

surgical repair or unblocking of a blood vessel