Switch gears here a little bit too peripheral arterial
disease, all coming under the classification
of peripheral vascular disease. But if it
is peripheral arterial, let us talk about
the most common cause in this, up and down
the body will be atherosclerosis. Atherosclerosis,
we had a discussion in terms of the pathogenesis
of a atheroma including the fact that there
was endothelial injury within a blood vessel
resulting in a thrombi formation, resulting
in recruitment of some of those smooth muscle cells,
coming from the media to the intima, all contributing
to the fibrous cap, do you remember that discussion?
If not then it might be a good idea for you
to go back and take a look at what is the
developmental process of an atheroma. Once
you understand the developmental process, you
can go on and put that atheroscotic plaque in blood
vessels and, therefore, bring about the clinical
manifestations of that blood vessel involved.
For example, if it is peripheral arterial
disease, then you know your patient is going
to suffer from "angina of the leg", in other
words, claudication. If it is coronary arterial
disease, then there will be something like
your angina for sure with chest pain or erectile
dysfunction or issues with transient ischemic
attack. Right? Up and down the body, atherosclerosis.
But here let us focus upon the periphery, shall
we? Some patients develop ischemia and if
it is bad enough could result in several issues
to the point where perhaps there is even gangrene.
You don't want that. Like coronary artery
the symptoms are going to be the same thing
that we saw earlier for angina and our discussion
there brought us into two major physiological
classifications. It was the supply and the
demand. The more there is demand you need
to make sure that there is supply. Isn't that
how business works? Therefore, you are demanding
excellence. I am hopefully supplying you
with that information. The demand here has
increased, may be the supply isn't sufficient.
So, why coronary arterial disease. That is
what you saw with angina. The same type of
issue might be taking place in the periphery
artery. So what is the patient going to feel?
Pain. What do we call this? Claudication. Shall we?