Peripheral vascular disease case study

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Peripheral Vascular Disease Case Studies A year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except for decreased hair on the right leg.
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Atherosclerosis

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RACGP - Painful black toe – a case study

Peripheral Vascular Disease Case Studies A year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except for decreased hair on the right leg. The patients popliteal, dorsalis pedis, and posterior tibial pulses were markedly decreased compared with those of his left leg. Studies Results Routine laboratory work Within normal limits WNL Doppler ultrasound systolic pressures Femoral: mm Hg; popliteal: 90 mm Hg; posterior tibial: 88 mm Hg; dorsalis pedis: 88 mm Hg normal: same as brachial systolic blood pressure Arterial plethysmography Decreased amplitude of distal femoral, popliteal, dorsalis pedis, and posterior tibial pulse waves Femoral arteriography of right leg Obstruction of the femoral artery at the midthigh level Arterial duplex scan Apparent arterial obstruction in the superficial femoral artery Diagnostic Analysis With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery.
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Painful black toe

Background: Serum phosphorus P and the product of serum calcium x serum P Ca x P , are frequently elevated in end-stage renal disease patients on maintenance hemodialysis HD. Elevated P and Ca x P have been associated with vascular calcification in dialysis patients. Methods: This nested case-control study is drawn from the 11 incident PVD events reported in the cohort of the Secondary prevention with antioxidants of cardiovascular disease in end-stage renal disease SPACE : a randomized placebo-controlled trial. PVD was defined clinically and confirmed ultrasonographically. In multivariate analysis, adjustment was made for variables dissimilar by PVD status including underlying renal disease, diabetes, smoking, history of angina pectoris, prescription for vitamin D3, erythropoietin, calcium channel blockers and aspirin.
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This week I saw a patient with terminal peripheral vascular disease PVD. Seeing him reminded me of how often the severity of this disease is misunderstood. He had had amputation of the toes on his right foot due to gangrene.
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