Understanding Peripheral Arterial Disease
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- Опубликовано: 17 дек 2022
- This video contains a visual explanation of peripheral arterial disease, aimed at helping students of medicine and healthcare professionals prepare for exams.
Written notes on peripheral arterial disease can be found at zerotofinals.com/surgery/vasc...
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I am a retired RN, and find this to be an excellent video, easy to understand, and has me hungry for more. Thank you.
Awareness is key to saving lives, we support the efforts to educate and provide the patient care.
I am not a medical student. This is the best video I found so far on RUclips on this subject. Thank you again.
Totally agree with you.
Make that 3 of us!
🎯 Key Takeaways for quick navigation:
00:00 🩸 *Introduction to Peripheral Arterial Disease*
- Peripheral arterial disease (PAD) is the narrowing of arteries supplying the limbs, reducing blood supply.
- Symptoms include claudication, intermittent crampy pain during exertion, and critical limb ischemia, indicating inadequate blood supply at rest.
- Acute limb ischemia is a rapid onset of limb ischemia, often caused by a thrombus blocking arterial supply.
02:24 🛢️ *Understanding Atherosclerosis*
- Atherosclerosis is the combination of atheromas (fatty deposits) and sclerosis (hardening) in arteries.
- Chronic inflammation and immune system activation lead to lipid deposition, fibrous plaques, and arterial stiffening.
- Plaques cause stenosis, hypertension, and can lead to thrombus formation, resulting in conditions like angina or acute coronary syndrome.
03:40 🚦 *Atherosclerosis Risk Factors*
- Non-modifiable risk factors: older age, family history, and being male.
- Modifiable risk factors: smoking, alcohol consumption, poor diet, sedentary lifestyle, obesity, and medical comorbidities (diabetes, hypertension).
- Considering these factors is crucial when suspecting atherosclerotic diseases.
05:58 💔 *End Results of Atherosclerosis*
- Atherosclerosis can lead to various conditions, including angina, myocardial infarction, strokes, peripheral arterial disease, and chronic mesenteric ischemia.
06:17 🚶 *Intermittent Claudication in PAD*
- Intermittent claudication presents as predictable crampy pain during walking, relieved by rest.
- Critical limb ischemia exhibits the "six P's": pain, palour, pulseless, paralysis, paresthesia, and perishingly cold.
- Larice syndrome involves thigh claudication, absent femoral pulses, and male impotence.
09:07 🕵️ *Signs of PAD on Examination*
- Look for risk factors like tar staining, xanthomas, and signs of existing cardiovascular disease.
- Palpate various peripheral pulses and use a handheld Doppler if pulses are difficult to feel.
- Inspect for skin changes, muscle wasting, ulcers, and poor wound healing.
10:21 🛏️ *Burger's Test for PAD*
- Burger's test helps assess PAD. The angle at which legs turn pale indicates inadequate blood supply.
- In sitting position, legs in PAD first turn blue and then dark red due to deoxygenation and vasodilation.
- Useful in diagnosing PAD when examining patients with suspected vascular issues.
12:08 💔 *Arterial and Venous Leg Ulcers*
- Arterial ulcers are smaller, deeper, well-defined, occur more peripherally, bleed less, and are painful.
- Venous ulcers are larger, superficial, have irregular borders, occur in the gator area, and are less painful.
- Distinguishing features help determine the type of leg ulcer and guide appropriate management.
13:33 🧪 *Investigations for PAD*
- Ankle Brachial Pressure Index (ABPI), duplex ultrasound, and angiography aid in PAD diagnosis.
- ABPI ratios help indicate the severity of PAD, ranging from normal to severe disease.
- These investigations assist in planning appropriate treatment strategies.
15:15 🏃♂️ *Management of Intermittent Claudication*
- Lifestyle changes target modifiable risk factors, including smoking cessation and optimal treatment of medical conditions.
- Exercise training, medical treatments (atorvastatin, clopidogrel, aspirin), and vasodilator medications help improve blood flow.
- Surgical options, like angioplasty, endarterectomy, and bypass surgery, may be considered for severe cases.
17:21 ⚠️ *Management of Critical Limb Ischemia*
- Urgent referral to the vascular team is crucial.
- Revascularization through endovascular procedures or surgery may be necessary.
- Amputation might be considered if restoring blood supply is not possible.
17:54 🚨 *Management of Acute Limb Ischemia*
- Urgent referral to the on-call vascular team is essential.
- Management options include endovascular thrombolysis, thrombectomy, surgical thrombectomy, endarterectomy, bypass surgery, or amputation.
- Prompt intervention is vital to restore blood supply and prevent irreversible tissue damage.
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Gonna be a bit long so I apologize now.
I'm from Ontario Canada. Watched this video in November and just revisiting now to say I'm very grateful for this easily explained and very informative video. To make a long story short, on October 15th just past, I had Femoral angioplasty and right Illiac stent surgery and was discharged from the hospital with much pain and couldn't not walk needing assistance. 3 days later I ended up readmitted to hospital another 4 days on Heparin for a large blood clot behind my knee. It wasn't until I came across this video while researching vascular calf/thigh/butt pain symptoms when walking and Dr. "Lingo" to have my Vascular Dr. understand what I kept attempting to explain. I had never heard of Intermittent Claudication and what it was before your video but it was exactly what I was describing.
After seeing your video, I used those words to my Vascular specialist and that is when he told me I also had a 3rd narrowing at 70% located by the back of my knee that was left alone in favour of the Femoral and Iiliac areas. Finally we were on the same page and he scheduled me in for day surgery which I had Dec.13th. QUESTION: WAS THIS BLOOD CLOT CONSIDERED THOMBON OR THROMBOSIS WHICHEVER IT'S CALLED?
CAN'T THANK YOU FOR THIS VIDEO ENOUGH
Amazing video and great way of teaching! Thank you so much!
This channel is so very beneficial. Thank you!
Glad to help! Thanks :D
Inspiring way of teaching! Congratulations!
Glad you liked it!
Concise to the highest level !
Thank you for always leaving a comment!
@@ZeroToFinals yes. He is always 🤭
Thank you for making this it's so helpful
Best on this topic
Very clear and concise information on this important topic. ❤
Wow amazing information, I’ve just suffered 3 TIA’s and have a scan on my neck veins ( apologies for the non technical term) I’m not medically trained. This video will help me better understand what the doctor is talking about and hopefully allow me to ask relevant questions. Thank you.
1
Great video, very helpful
"If you like this video ..." lol
everyone (including me) LOVES your videos !
Thanks!
Superb.....way of presentation is on another level!❤
Excellent! Keep 'em comin'! Just love 'em!
Thanks! Will do!
Great explanation
Thank you💜💙
Geesh! Don't know how or why this showed up in my RUclips surfing but I'm grateful that it did. I have many of these issues. Now i know to seek out my PAD ratio score.
Best video ive seen so far💯
Thanks!
Thanks❤
AMAZING VIDEO !
thanks Sir
Thank you for a lecture. Bj Slovenia
Acute limb ischemia means 6 p's but critical limb ischemia means (rest pain and gangrene or ulcer not healed )
Whom to consult for PAD patient. (Medical speacialist)
Thank you keep going
Outstanding…..again
Thanks!
Liked and Subscribed.
My top of my leg is a reddess color and the bottom is normal color and my left ankle swells and toes turn purple on both feet can a injury cause my left ankle to be worse than my right. I'm fixing to have two types of tests for my left left and dulex arteries check out again what's your opinion on this.
Can you share the final diagnosis ?
I have been diagnosed with this a few months ago. Can someone tell me if intense itching is a symptom? Scratching does not help at all.
Superb
Thanks 🤗
Nice!
Thanks!
Good. Now lets use these details of deterioration to measure the success of diet and nutrient controls. I have already softened a hardened area of my calves by eating less saturated fats, plus other changes.
What can be the cause of Atherosclerosis - I have M.S. can that be why? Also my family dr is sending me for a Vascular test. I’m not sure if is Atherosclerosis what I have as of yet… but I have cramps in my legs, calves feet and coldness like no circulation to my feet and calves at times and tingling and heavy legs. I also have Mottling of the skin on my legs and my chest and arms. I’m very worried pls respond thank you. ❤
Very advantageable Section specificaly to the bigginer
I have just been diagnosed with this and ruemitoide arthritius the pain is in my right side
Could you please elucidate in another video as to "why" smoking specifically is so dangerous to PAD. Everybody says so but nobody has ever said why smoking causes PAD.
The chemicals and bad stuff in cigarettes narrows blood vessels in the brain. The brain needs oxygenated blood which is destroyed by smoking. I smoked 10 yrs on; 10 yrs off. Yet it’s all ‘cumulative’ and even though I am now 77 yrs old and cigarette free another 10 years, the chickens are coming home to roost! An ultrasound just showed ‘mild to moderate plaque’ in both legs! As an appointment with a cardiologist is at least a month away, meanwhile I am focusing on aquatic physical therapy and a major overhaul of my poor nutrition! Only symptom was calf soreness in both legs noted whenever getting out of bed. All my life I’ve had cold feet and hands. (Added to by chemo 2 years ago!) No cardiac family history- just poor lifestyle choices. No painful neuropathy, and blood pressure under control with 25 mg Losartan. These ‘tents’ do eventually wear out, but it is our responsibility to protect our health and make appropriate positive lifestyle choices. 😅
I had it on both legs. It hurts when i walked. I had to get a bypass on both legs. Thank God they saved both of my legs.
How to diagnose?? Plz help
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Duas pessoas de cem pessoas será sempre dois porcento, hoje, ontem e amanhã. Onde iremos parar?
1100 am 12/22. I have pad. Nitric oxide does not help. I'm in top shape hike 5 to 10 miles lift heavy wgts..beet root causes kidney stones, etc. I'm hiking with much pain.. need better help
Vascular surgeons are not helping.
How do I reach you
?
I have used morphine also. It does not help.vasodialators do not help much
Got itchy foot and ankle after getting hearth attack got cream from doctors since last two years nothing helped it itch it something terrable
Tough because dark skin doesn't change color and stuff like that.