Peripheral Arterial Disease: Difference between revisions
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In the United Kingdom, an estimated 500-1000 new cases of PAD are diagnosed per million each year<ref name="Patient">Patient. Peripheral arterial disease. http://www.patient.co.uk/doctor/peripheral-arterial-disease (accessed 9 May 2015)</ref><ref name="Peach">Peach, G, Griffin, M, Jones, KG, Thompson MM, Hinchliffe, RJ. Diagnosis and management of peripheral arterial disease. BMJ 2012; 345: 1-8. http://www.bmj.com/content/bmj/345/bmj.e5208.full.pdf (acccessed 9 May 2015)</ref>. Patients at high risk of PAD are those with cardiac disease, diabetes mellitus, older than 70 years or 50 years old with multiple cardiovascular factors<ref name="Mahameed">Mahameed, AA, Bartholomew, JR, Disease of Peripheral Vessels. In: Topol, EJ, editor. Textbook of Cardiovascular Medicine. 3rd ed. New York: Lippincott Williams &amp;amp;amp;amp;amp;amp;amp;amp;amp; Wilkins, 2007, p.1531-1537</ref>. These factors include smoking, dyslipedmia, dysglycemia, hypertension, family history of atherosclerotic vascular disease. In lower socioeconomic areas, PAD is more frequent as a result of increased incidence of smoking <ref name="Fowkes">Fowkes G. Peripheral vascular disease. 2010. http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/HCNA/09HCNA3D2.pdf (accessed 9 May 2015)</ref>. Some studies report no difference in prevalence between the sexes <ref name="Mahameed " />, however, other studies have found a 3:1 ratio comparing men to women<ref name="Fowkes" /><ref name="Patient" />. A few studies have suggested that black non-Hispanics have an increased prevalence of PAD, with a reported 2.39 to 2.83 odd ratio. Although, a study that controlled for atherosclerotic risk factors found a small difference between whites and African Americans; 1.54 and 1.89, respectively<ref name="Collins">Collines, TC, Petersen, NJ, Suarez-Almazor, M, Ashton CM. Ethnicity and peripheral arterial disease. Mayo Clin Proc. 2005; 80(1): 48-54.</ref>. The majority of cases are asymptomatic.. | In the United Kingdom, an estimated 500-1000 new cases of PAD are diagnosed per million each year<ref name="Patient">Patient. Peripheral arterial disease. http://www.patient.co.uk/doctor/peripheral-arterial-disease (accessed 9 May 2015)</ref><ref name="Peach">Peach, G, Griffin, M, Jones, KG, Thompson MM, Hinchliffe, RJ. Diagnosis and management of peripheral arterial disease. BMJ 2012; 345: 1-8. http://www.bmj.com/content/bmj/345/bmj.e5208.full.pdf (acccessed 9 May 2015)</ref>. Patients at high risk of PAD are those with cardiac disease, diabetes mellitus, older than 70 years or 50 years old with multiple cardiovascular factors<ref name="Mahameed">Mahameed, AA, Bartholomew, JR, Disease of Peripheral Vessels. In: Topol, EJ, editor. Textbook of Cardiovascular Medicine. 3rd ed. New York: Lippincott Williams &amp;amp;amp;amp;amp;amp;amp;amp;amp; Wilkins, 2007, p.1531-1537</ref>. These factors include smoking, dyslipedmia, dysglycemia, hypertension, family history of atherosclerotic vascular disease. In lower socioeconomic areas, PAD is more frequent as a result of increased incidence of smoking <ref name="Fowkes">Fowkes G. Peripheral vascular disease. 2010. http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/HCNA/09HCNA3D2.pdf (accessed 9 May 2015)</ref>. Some studies report no difference in prevalence between the sexes <ref name="Mahameed " />, however, other studies have found a 3:1 ratio comparing men to women<ref name="Fowkes" /><ref name="Patient" />. A few studies have suggested that black non-Hispanics have an increased prevalence of PAD, with a reported 2.39 to 2.83 odd ratio. Although, a study that controlled for atherosclerotic risk factors found a small difference between whites and African Americans; 1.54 and 1.89, respectively<ref name="Collins">Collines, TC, Petersen, NJ, Suarez-Almazor, M, Ashton CM. Ethnicity and peripheral arterial disease. Mayo Clin Proc. 2005; 80(1): 48-54.</ref>. The majority of cases are asymptomatic.. | ||
== Aetiology== | == Aetiology == | ||
The | Atherosclerosis accounts for the majority of PAD, whereas uncommon vascular symptoms, such as vasculitis, thromboangiitis obliterans, popliteal entrapment syndrome, and fibromuscular dysplasis, account for less than 10% of cases <ref name="Mahameed" />. Atherosclerosis is the formation of lipid deposits in the tunica media and associated with damage to the endothelial lining <ref name="Martini">Martini, FH, Nath, JL, Bartholomew, EF. Fundamentals of anatomy and physiology. San Francisco: Pearson Education, 2015.</ref>.The endothelial cells become swollen with lipids and create a gap between in the linings. Platelets stick to the exposed collagen fibers, forming a localized clot that restricts arterial blood flow, leading to inadequate tissue perfusion. This and other complex interactions can lead to progression from asymptomatic PAD, Intermittent Claudication, Critical Limb Ischemia, Acute Limb Ischemia <ref name="Mahameed" />.<br> | ||
== Investigations == | == Investigations == |
Revision as of 15:09, 24 May 2015
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Definition/Description[edit | edit source]
Definition of the disease or condition
Epidemiology[edit | edit source]
In the United Kingdom, an estimated 500-1000 new cases of PAD are diagnosed per million each year[1][2]. Patients at high risk of PAD are those with cardiac disease, diabetes mellitus, older than 70 years or 50 years old with multiple cardiovascular factors[3]. These factors include smoking, dyslipedmia, dysglycemia, hypertension, family history of atherosclerotic vascular disease. In lower socioeconomic areas, PAD is more frequent as a result of increased incidence of smoking [4]. Some studies report no difference in prevalence between the sexes [3], however, other studies have found a 3:1 ratio comparing men to women[4][1]. A few studies have suggested that black non-Hispanics have an increased prevalence of PAD, with a reported 2.39 to 2.83 odd ratio. Although, a study that controlled for atherosclerotic risk factors found a small difference between whites and African Americans; 1.54 and 1.89, respectively[5]. The majority of cases are asymptomatic..
Aetiology[edit | edit source]
Atherosclerosis accounts for the majority of PAD, whereas uncommon vascular symptoms, such as vasculitis, thromboangiitis obliterans, popliteal entrapment syndrome, and fibromuscular dysplasis, account for less than 10% of cases [3]. Atherosclerosis is the formation of lipid deposits in the tunica media and associated with damage to the endothelial lining [6].The endothelial cells become swollen with lipids and create a gap between in the linings. Platelets stick to the exposed collagen fibers, forming a localized clot that restricts arterial blood flow, leading to inadequate tissue perfusion. This and other complex interactions can lead to progression from asymptomatic PAD, Intermittent Claudication, Critical Limb Ischemia, Acute Limb Ischemia [3].
Investigations[edit | edit source]
This may well include any investigations used to gain a diagnosis or that you might need to gain information about your patient assessment.
Clinical Manifestations[edit | edit source]
Clinical manifestations (the signs and symptoms your patient may well present to you on an examination) ensure you relate this back to the underlying pathophysiology.
Physiotherapy and Other Management[edit | edit source]
Physiotherapy and other management. Other health professionals will be treating your patient. What is their input?
Prevention[edit | edit source]
Brief consideration of how this pathology could be prevented and the physiotherapy role in health promotion in relation to prevention of disease or disease progression.
Resources
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add appropriate resources here
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ 1.0 1.1 Patient. Peripheral arterial disease. http://www.patient.co.uk/doctor/peripheral-arterial-disease (accessed 9 May 2015)
- ↑ Peach, G, Griffin, M, Jones, KG, Thompson MM, Hinchliffe, RJ. Diagnosis and management of peripheral arterial disease. BMJ 2012; 345: 1-8. http://www.bmj.com/content/bmj/345/bmj.e5208.full.pdf (acccessed 9 May 2015)
- ↑ 3.0 3.1 3.2 3.3 Mahameed, AA, Bartholomew, JR, Disease of Peripheral Vessels. In: Topol, EJ, editor. Textbook of Cardiovascular Medicine. 3rd ed. New York: Lippincott Williams &amp;amp;amp;amp;amp;amp;amp;amp; Wilkins, 2007, p.1531-1537
- ↑ 4.0 4.1 Fowkes G. Peripheral vascular disease. 2010. http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/HCNA/09HCNA3D2.pdf (accessed 9 May 2015)
- ↑ Collines, TC, Petersen, NJ, Suarez-Almazor, M, Ashton CM. Ethnicity and peripheral arterial disease. Mayo Clin Proc. 2005; 80(1): 48-54.
- ↑ Martini, FH, Nath, JL, Bartholomew, EF. Fundamentals of anatomy and physiology. San Francisco: Pearson Education, 2015.