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Peripheral Vascular Disease: Definition

by Carlo Raj, MD
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    00:02 Welcome back ladies and gentlemen here we take a look vascular diseases. Now, what we are not covering is a vascular disease in great detail because that is not what this lecture series is about. In fact, it is about arrhythmias. Under arrhythmias, we had two categories or classifications. We had those that were dealing with conduction system diseases and under conducting system diseases and dysarrythmias, we looked at those four major atrial issues and SVTs and we looked at ventricular arrythmias. We are now going to move into our vascular disease portion where will take a look at in great detail peripheral vascular diseases either due to perhaps venous insufficiency, peripheral arterial disease, and aortic dissection. That will then complete the entire picture of arrythmias in totality.

    00:57 Peripheral vascular disease in general terms. Well, what if there is venous insufficiency? What does that mean? Your valves, the one way valves and which it allows the blood to be guaranteed to move forward is not occurring. The valves might be incompetent and if they are, remember, for example, think about your leg and the veins down there and how do you get them up into the heart? How do you move it forward? Ambulation, movement in between the muscles there is squeezing ensuring that the blood is moving forward. But what if the valves aren't working properly? Resulting in venous insufficiency. What is my topic? Peripheral vascular disease specifically under the classification of arrythmia. Then peripheral arterial disease. What may then cause this? Well peripheral arterial disease, there might be a disease within the artery which is then causing it to narrow. Where? Down in the periphery. How would you know, what kind of tests that you need to conduct so that you know for sure that you are dealing with a peripheral arterial disease versus a coronary arterial disease. We shall have a look when the time is right. With venous insufficiency the peripheral pooling due to abnormal change of the LE stands for lower extremity veins. Examples or etiology for this includes obesity, diabetes mellitus type II, varicose veins. What are these? Because medically perhaps thought of by the patient as being unacceptable. The superficial veins, think about the saphenous down in the legs, may be the valves there aren't working properly and so, therefore, resulting in varicose veins.

    02:43 Lymphatic obstruction, what is my topic? Venous insufficiency and these are various differentials.

    02:50 Chronic lower extremity edema with brownish discoloration of the skin mean to say that with venous insufficiency at some point the overlying skin is going to present with abnormalities that you want to be extremely astute about. Treat the underlying disease, for example, we talked about in the previous discussion, about diabetes, maybe obesity. Venous stripping of the varicosities and by that we mean that if the superficial veins are not properly moving the blood forward and you have pooling of it, you strip the varicosities.

    03:29 Compression therapy, for example, hoisery or bandages, especially if your patient that has been sitting around postoperatively in a bed for long periods of time, you want to make sure that there is proper compression therapy, so that you do not allow the blood remaining for a long period of time, because there is every possibility that the patient may then develop a DVT and, more importantly, prone to a PE or a pulmonary embolus.


    About the Lecture

    The lecture Peripheral Vascular Disease: Definition by Carlo Raj, MD is from the course Arrhythmias.


    Included Quiz Questions

    1. Brownish discoloration of the skin
    2. Edema
    3. Varicosities
    4. Tissue necrosis
    5. Pain
    1. Atherosclerosis
    2. Obesity
    3. Lymphatic obstruction
    4. Varicose veins
    5. Diabetes mellitus type 2
    1. All are correct
    2. Simulates venous compression by muscles.
    3. None are correct
    4. Helps to avoid development of thrombosis
    5. Forces blood to move against gravity

    Author of lecture Peripheral Vascular Disease: Definition

     Carlo Raj, MD

    Carlo Raj, MD


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