- Progressive atherosclerosis
- Myocardial infarct is most common cause of HefRef in US
- HTN
- DM
- Past MI
- Hyperlipidemia
- Smoking
- Family history
- Male
- Cocaine use
- Chest pain, sweating, nausea w/acute ischemia
- PND and Orthopnea w/CHF
- Claudication if co-existent PAD
- Elevated JVP, crackles on lung exam, distal edema w/CHF
- Sometimes evidence of distal atherosclerosis: diminished posterior tibialis and dorsalis pedis pulses
- Delayed capillary refill, cool extremities, distal extremity ulcers