peripheral artery disease - bmh/tele

Peripheral Artery DiseasePeripheral Artery Disease

Natalie Bermudez, RN, BSN, MSNatalie Bermudez, RN, BSN, MSClinical Educator for Cardiac TelemetryClinical Educator for Cardiac Telemetry


“Hardening of arteries” - atherosclerosis

Caused by plaque accumulation on arterial walls – thrombus formation - stenosis


Occludes blood flow in peripheral arteries – arms and legs


Causes acute or chronic ischemia

May cause an embolus


ETIOLOGY:

SmokingDiabetes Mellitus

DyslipidemiaHypertension


Increased Risk:Increased Risk:50 years old

MaleAfrican American

ObesePersonal history of vascular

disease, MI, or stroke


Fontaine Stages:Fontaine Stages:I: mild pain on walking

("claudication") II: severe pain on walking relatively

shorter distances (intermittent claudication)

III: pain while resting IV: loss of sensation to the lower

part of the extremity V: tissue loss (gangrene)


Tissue Necrosis

a.k.a. Gangrene

Peripheral Artery DiseasePeripheral Artery DiseaseOther Signs & Symptoms:Other Signs & Symptoms:

Discoloration to affected extremity

Peripheral Artery DiseasePeripheral Artery DiseaseDiagnostic Diagnostic EvaluationEvaluation::

Arterial-Brachial Index (ABI)

Peripheral Artery DiseasePeripheral Artery DiseaseDiagnostic Evaluation:Diagnostic Evaluation:

Doppler ultrasoundMulti-slice CT scan


Treatment:Treatment:Smoking cessationRegular exerciseAngioplasty/PTCABypass graftingSympathectomyDigit/Limb Amputation


Medication Regimen:Medication Regimen:AspirinPlavix (clopidogrel)Statins


Prognosis for patients with PAD is Prognosis for patients with PAD is very poorvery poor

Occasionally thrombolysis Occasionally thrombolysis treatment is successfultreatment is successful

peripheral artery disease - bmh/tele

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