3BDS: CVD4

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what is peripheral vascular disease
Atherosclerosis affecting peripheral (arteries) vessels
- In lower limbs
- Abdominal aorta

Chronic insufficiency blood supply to feet can cause an infarction of the feet. (pulseless, painful, numb feet
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what are the symptoms of chronic ischaemia in feet (+what is intermittent claudication)
symptoms of chronic claudation:
skin changes (ulcers, hair loss), nail changes (brittle),
intermittent claudication= leg pain typically in calf occurring when walking a distance, relieved by resting
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what are the symptoms of critical limb ischaemia (embolus or atherosclerosis plaque rupture)
acute ischaemia of lower limb
may be a background of intermittent claudication, severe constant pain in foot, calf, leg at rest
pale, pulseless, perishing cold, paralysis, paraesthesia of limb, gangrene, limb threatening.
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what is the management of PVD
• Risk factor modification (stopping smoking, managing hypertension/ diabetes/weight, diet)
• Exercise programme
• Surgery (bypass grafts, stents, amputation of limb)
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What is PVD- abdominal aortic aneurysm

symptoms
damage to vessel wall from atherosclerosis = dilated aorta. risk of catastrophic rupture or tear

often asymptomatic, sometimes vague abdominal pain, often presents acutely with rupture- Collapse, severe abdominal pain, surgical emergency, high mortality
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how does ischaemic heart disease manifest as
• Stable angina – exertional
• Acute coronary syndrome- symptoms as rest (unstable angina, myocardial infarction)
• Heart failure
• Arrhythmias
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what is the difference between ischaemia and Myocardial infarction
Ischaemia results when the heart muscle is starved for oxygen and nutrients due to atherosclerosis . When damage or death of part of the heart muscle occurs as a result of ischaemia= MI
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how does ischaemic heart disease manifest as stable angina
due to narrowing of coronary arteries by atherosclerosis.
lack of blood (oxygen) to heart- ischaemia- visceral pain
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what are the symptoms of angina
exertion central chest pain radiating down left arm. atypical= jaw, back, upper abdomen
can often be perceived as heaviness or breathlessness. sometimes associated nausea. often gets better with rest and nitrates if patient has a GTN spray
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what is the management of stable angina
- Lifestyle modification (adjust modifiable risk factors)
- Managing underlying medical conditions (diabetes, HBP, cholesterol)

- Medical management
Anti platelets-> aspirin, clopidogrel
Cholesterol-> statin
Symptom relief-> vasodilators= beta blockers
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what is acute coronary syndrome
unstable angina (myocardial ischaemia), myocardial infarction (both present with the same symptoms, with ate most often due to atherosclerosis of coronary arteries )
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what are the symptoms of acute coronary syndrome
- more severe than angina but sometimes indistinguishable.
-central crushing chest pain at rest or on minimal exertion
- pain maybe felt as indigestion, radiation does left arm or to jaw
- often clammy, nauseated, dizzy, breathless
- feeling of imminen
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what is the management of acute coronary syndrome
1. phone 999
2. sit the patient up
3. give high flow oxygen
4. give GTN spray 2 puffs sublingually (up to 3 doses 5 min apart)
5. give aspirin 300mg

also- send someone for the AED, ABCDE assessment , stay with patient, give 3 doses GTN 5 min apart, write
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Why shoudnt you give intramuscle injection to patients with acute coronary syndrome
if given anti-platelets in hospital, they will bleed
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Other cards in this set

Card 2

Front

what are the symptoms of chronic ischaemia in feet (+what is intermittent claudication)

Back

symptoms of chronic claudation:
skin changes (ulcers, hair loss), nail changes (brittle),
intermittent claudication= leg pain typically in calf occurring when walking a distance, relieved by resting

Card 3

Front

what are the symptoms of critical limb ischaemia (embolus or atherosclerosis plaque rupture)
acute ischaemia of lower limb

Back

Preview of the front of card 3

Card 4

Front

what is the management of PVD

Back

Preview of the front of card 4

Card 5

Front

What is PVD- abdominal aortic aneurysm

symptoms

Back

Preview of the front of card 5
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