Peripheral Arterial Disease: Pathogenesis

00:00 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.

01:01 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.

01:26 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.

01:37 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?