Peripheral Arterial Disease (PAD) - Subacute/Chronic

Etiology

  • From progressive atherosclerosis

Risk Factors

  • Hypertension, hyperlipidemia, diabetes, smoking, known vascular disease, increased age, male

Symptoms

  • Aching discomfort in leg/calf that's worse w/activity and better w/rest
  • With severe PAD→ aching improves w/dangling legs off table (takes advantage of gravity)
  • Progressive ulcers, which affect distal leg most commonly - in particular over lateral malleolus
  • At risk for superimposed infection of skin and bone

Physical Exam Findings

  • Diminished or absent distal pulses (dorsalis pedis and posterior tib)
  • Sometimes femoral bruit
  • Decreased cap refill
  • Feet cool to touch
  • Sometimes shallow ulcers first
  • At risk for deeper ulcers, infxn/osteomyelitis, and gangrene w/advanced disease

Links