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:
- Pallor
- Pain
- Paraesthesia
- Paralysis
- Pulselessness
- 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