som
Forum Guru
Topics: 59
Posts: 308
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A 63 yr male with 6mnth h/o intermittent claudication. no nocturnal or rest pain.
h/o DM, HTN, hypercholestermia. h/o smoking+
meds-amlodipine, ramipril,atorvastatin
VS:BP:150/90 Pulse:70/min
on/e- lossof hair on legs, brittle toenails bilaterally, weak fempral and popliteal pulses but present.
distal leg pulses are absent bilaterally.
que: next appropriate step of Mx:
angiogram to determine extent of dz
surg. revascularization
aspirin and exercise
sympathectomy
angioplasty
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| study_ing
Forum Fanatic
Topics: 180
Posts: 2,511
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aspiirin and excercise
just guessing..
definitely need aspirin..( HTN, evidence of atherosclerotic dz, DM)
duznt seem so bad to require surgery as the NEXT step
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| som
Forum Guru
Topics: 59
Posts: 308
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your guess is absolutely right
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| tolito
Forum Fanatic
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agree.
asides from which, he is a poor candidate for revascularisation. the same disease process will clog up his 'new' vessels. right??
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| brucella2007
Forum Junior
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but in every pt with PVD that wud be the case..so when do we opt for surgery, etc ?
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| robin082006
Forum Hero
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aspirin and excercise, stop smoking, control HPand Dm
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| chinda11
Forum Junior
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Posts: 48
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how about doing arteriogram and knowing what is the extent of teh disease before we decide on the treatment. ? Some one please explain.
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| SilatK
Forum Guru
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Actually it is aspirin and exercise and then it would be angiography. Surgery if possible would be after angiogram.
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| chemamr
Moderator and PGY1
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ASA, exercise and stop smoking
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| saadtazjam
Forum Elite
Topics: 9
Posts: 160
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in elderly retired patients i think we advice to stop smoking and manage conservatively,however if the patient is young and is afffecting his job functions we go for angiography and proceed to surgery.please correct me if i am wrong.i didnot understand why we tell the patient to exercise,how is it going to help,please make me understand?
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