Cardiovascular System >
Peripheral Vascular Disease (PVD)

“A circulation disorder that causes the blood vessels outside of your heart and brain to narrow, block, or spasm.”

  • Forms of Peripheral Vascular Disease:
    • Functional PVD (FPVD)
    • Organic PVD (OPVD)
Risk Factors
  • Age >50
  • Overweight
  • High cholesterol
  • History Stroke
  • Diabetes
  • High blood pressure
  • Family History
Aetiology
  • FPVD – Emotional stress, cold temperatures, operating vibrating machinery or tools, drugs
  • OPVD – Smoking, high blood pressure, diabetes, high cholesterol
Pathophysiology
  • FPVD – Vessels exaggerate their response (dilation or constriction) to the environment which affects the flow
  • OPVD – A change in the structure of the blood vessel (e.g. plaque development due to atherosclerosis) which reduces the flow
Clinical Presentation
  • The 6 Ps:
    1. Pallor
    2. Pain
    3. Paraesthesia
    4. Paralysis
    5. Pulselessness
    6. Poikilothermia
  • The most common presenting symptoms are claudication, skin changes or wounds that won’t heal
Investigations
  • Bloods: n/a
  • Imaging:
    • Angiogram
    • Doppler ultrasound flow studies
    • Magnetic resonance angiography (MRA)
  • Special:
    • Ankle-brachial index (ABI)
    • Treadmill exercise test
    • Pulse volume waveform analysis
Management
  • Conservative:
    • Lifestyle changes
  • Medical:
    • Aggressive treatment of existing conditions that may worsen PVD
    • Antiplatelet medication – Aspirin / Clopidogrel
  • Surgical:
    • Vascular surgery
    • Angioplasty
      • Balloon angioplasty
      • Atherectomy
      • Laser angioplasty
      • Stent
Complications
  • Tissue death (can lead to limb amputation)
  • Impotence
  • Pale skin
  • Pain at rest and with movement severe pain that restricts mobility
  • Wounds that don’t heal
  • Osteomyelitis

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