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PVD and HTN
| Question | Answer |
|---|---|
| What are PAD RF | HTN, hyperlipidemia, DM, smoking, obesity, sedentary lifestyle, Females, older than 65, elevated CRP, hyperhomocysteinemia, family hx. |
| What are causes of PAD | atherosclerosis, inflammation, stenosis, thrombus, embolus |
| What is stage 1 of PAD | Asymptomatic: no claudication or pain, bruit may be heard, pedal pulses decreased or absent |
| What is stage 2 PAD | Intermittent claudication: muscle pain, burning, cramps with exercise (relieved with rest, reproducible with same amount of exercise) |
| What is stage 3 of PAD | Rest pain: pain at rest, numbness/burning and occurs in distal proportion of extremity, relieved by putting extremity in dependent position |
| Stage 4 of PAD | Necrosis or gangrene: ulcers and blacked tissue occur on toes, foot, or heel, gangrenous odor may be present |
| Clinical manifestations of PAD | can be asymptomatic, intermittent claudication, paresthesia, decrease capillary refills in toes, decreased or nonpalpable pulses, loss of hair on lower calf, ankle, foot, will be dry scaly, mottled skin, coly/cyanotic extremity, pallor (with elevation), R |
| Buerger's disease | inflamation and clotting in small/medium arteries of hands and feet, cause is unknown linked to immune response caused by smoking, males and smoking are RF, will have intermittent claudication, paresthesia, raynaud's phenomon, ulceration/gangrene of digit |
| Raynaud's disease | temporary, severe vasospasm in the arteries of fingers/toes in response to cold, overreaction to cold or stress, smoking and females, connective tissue or autoimmune disorder are at risk, will have Raynaud's phenomenon, numbness, pain, ulceration/gangrene |
| PAD treatment lifestyle modifications | wt. loss and diet management, smoking cessation, exercise regimen, promote vasodilation (warm environment, insulated socks, no direct heat), avoid cold, avoid stress, caffeine, and nicotine |
| PAD treatment positioning | avoid crossing legs, avoid tight/restrictive clothing, legs in dependent position, elevate legs (not above hear) |
| PAD treatment meds | Antihypertensives (beta blocker), antiplatelets (aspirin, clopidogrel, cilostazol), Statins (simvastatin, atorvastatin) |
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