Term
| Coronary Artery Disease (CAD) |
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Definition
| presence of atherosclerosis in coronary arteries which supply heart muscle with blood |
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Term
| Peripheral Arterial Disease (PAD) |
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Definition
| presence of systemic atherosclerosis in arteries distal to arch of aorta |
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Term
| Intermittent Claudication (IC) |
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Definition
| pain in one or both legs on walking, taht does not go away with continued walking & is relieved with rest |
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Term
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Definition
Age (elderly);
Race;
Cigarette Smoking;
Glycemic Control;
Dyslipidemia;
HTN;
Elevated homocysteine levels; |
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Term
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Definition
functional disability;
rest pain;
skin breakdown;
muscle atrophy;
amputation;
ischemic events; |
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Term
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Definition
aching, cramping pain, fatigue in leg muscles with exertion;
relieved with resting;
discomfort usually develops in muscle group distal to arterial obstruction; |
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Term
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Definition
spinal stenosis;
hip arthritis;
nerve root compression;
venous claudication; |
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Term
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Definition
rest pain sx, at night when limbs are horizontal;
if untreated, can lead to nonhealing wounds, gangrene, amputation; |
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Term
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Definition
absent or diminished pedal pulses;
presence of bruits over areas of stenosis;
shiny colored skin;
unilaterally cold extremity;
hair loss;
thickened, brittle toenails; |
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Term
| Ankle-Brachial Index (ABI) |
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Definition
comparison of SBP measurements from arm & ankle: ankle SP > brachial SP - Ankle:Brachial ratio >1;
Lower the Score --> greater risk for cardiac events, stroke, CV death; |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| higher right ankle pressure/higherarm pressure |
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Term
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Definition
| higher left ankle pressure/higher arm pressure |
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Term
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Definition
relieve symptoms of IC;
improve functional status & exercise tolerance;
prevent thrombotic events in circulation; |
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Term
| Risk Factor Modification in Tx of PAD |
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Definition
Smoking cessation;
Proper Tx of DM;
Tx HTN;
Tx of Dyslipidemia; |
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Term
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Definition
advise to stop smoking;
program of physician advice, group counseling sessions, and NRT; |
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Term
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Definition
screen & diagnose Type 2 DM;
Use antidiabetic therapy;
Goal: hemoglobin A1c <7%;
Proper foot care: appropriate footwear, skin cleansing/moisturizing, daily foot inspections, podiatry referral PRN; |
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Term
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Definition
initiate lifestyle modification in ALL pts w/ elevated BP: weight control, physical activity, sodium restriction, alcohol moderation;
Administer antihypertensive therapy to achieve goal BP: <140/90 mmHg or <130/80 mmHg if DM or renal insufficiency, <130/80 (AHC);
1st line: ACE-I;
Beta-blockers: no effect on claudication symptoms; |
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Term
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Definition
screening for lipid abnormalities important;
implement therapeutic lifestyle changes;
HMG-CoA reductase inhibitors (statins) are primary agents to lower LDL-C:
- Target LDL-C <100 mg/dL & non-HDL cholesterol <130 mg/dL;
- Optional goal: Target LDL-C <70 mg/dL & non-HDL cholesterol <100 mg/dL;
Fibrates and/or niacin to raise HDL-C & lower TGs; |
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Term
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Definition
considered a cornerstone of therapy for IC;
supervised rehabilitation programs are recommended;
Recommended:
- Time: >30 min;
- Schedule: >3 sessions/wk;
- Length: >3 months;
use treadmill and track walking;
Improves maximal walking time & overall walking ability; |
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Term
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Definition
antiplatelet therapy;
preferred due to lower cost, high incidence of concomitant CAD w/ PAD;
Dose: 75-325 mg PO daily;
low dose is protective, probably safer;
CHEST and ACC/AHA recommended 1st line; |
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Term
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Definition
antiplatelet therapy used in pts who are allergic or intolerant to aspirin;
Dose: 75 mg PO daily;
ADRs: thrombocytopenia; |
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Term
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Definition
used for lifestyle-limiting intermittent claudication;
Dose: 100 mg PO BID;
ADRs: HA, diarrhea, palpitations;
MoA: phosphodiesterase inhibitor;
C/I: congestive heart failure;
Improves maximal walking distance within 4-24 wks; |
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Term
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Definition
MoA: improves RBC deformability, lowers fibrinogen levels, retard platelet aggregation;
Dose: 400 mg PO TID;
ADRs: HA, dizziness, palpitations;
Conflicting results in clinical trials:
- CHEST does NOT recommend use;
- ACC/AHA says to consider as 2nd-line alternative to cilostazol to improve walking distance in pts; |
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Term
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Definition
balloon-tipped catheter guided into artery, advanced to narrowed/blocked vessel and then inflated to open a vessel; stenting may also be used;
shorter hospital stay & faster recovery compared to bypass surgery; |
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Term
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Definition
blood is re-routed from above an obstruction in artery to below an obstruction;
typically requiers general anesthesia & potential for systemic complications exist; |
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