Peripheral Vascular Disease

History

  • Claudication
    • Onset – When/How did it start? How far can you go before it starts?
    • Location – Blockage is one level above pain
    • Duration, Severity, Character
    • Alleviation/Aggravation – does it subside quickly with rest?
    • Symptoms associated – rest pain?
  • Risk factors
    • Known coronary artery disease (CAD)
    • Smoking
    • Hyptertension (HTN)
    • Dyslipidemia
    • Diabetes
    • Family history
  • Past medical history, medications, allergies

Physical Exam

  • Inspection: skin color, hair growth, ulcers/gangrene, missing limbs/digits, nail changes, texture of skin
  • Palpation: temperature, edema, capillary refill, pulses (dorsalis pedis, posterior tibialis, popliteal, femoral), abdominal aortic aneurysm
  • Auscultation: carotid bruits, femoral bruits
  • Blood pressure
  • ABI: dopper of foot arteries, inflate cuff around ankle to loss of sound, release pressure and note when sound returns

Imaging

  • Angiography
  • MRA
  • CTA
  • Duplex scan (carotid dopplers)

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