Peripheral Arterial Disease: Signs and Symptoms

00:00 Claudication, pain. Why? Insufficient, inadequate supply to the muscles o the legs, why? Peripheral arterial disease, why? Atherosclerosis, why? Maybe the patient is obese, maybe the patient has type II hyperlipoproteinemia a.k.a. hypercholesterolemia. Claudication and pain and depends. For example, "Hey doc, walking a few blocks and I have pain my thigh and then I stop and the pain goes away." Claudication.

00:36 Patients with severe pain, they will develop the following. Ischemic ulcerations of the skin and feet. Which patient are you truly worried about? A diabetic. Why? What is one of the first things that you would do in a patient with long standing diabetes who has come in perhaps for the first time for an actual examination? You are looking for those ubiquitous ulcers. What does that mean? You are looking for those ulcer that is on the dependent areas of the body and why? Why wasn't the patient able to tell you or feel the pain if there is skin eroding in this depending areas? Maybe the bottom of the feet? Because maybe with diabetes long standing, there is diabetic neuropathy and the pain was never triggered. Maybe the nerve has got shot. Right? So the combination. And what do you know a diabetic? Could they have atherosclerosis? Are you kidding me? Of course. So along with that and your ulceration and neuropathy, quite dangerous to the point where if the ulceration is not properly looked for and the ulceration continues and ischemia continues, what are you left with? Gangrene. Next step? Amputation. Rest pain, tissue necrosis, what does that mean? This is severe PAD. Would you tell me what kind of angina it is called when you are feeling pain even at rest with severe coronary arterial disease? That was called unstable angina, wasn't it? What do we have here? Severe peripheral arterial disease. We just talked about that gangrene, worst case scenario especially in a patient who is diabetic.