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som
Forum Elite Topics: 65 Posts: 358 |
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: 179 Posts: 2261
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 Elite Topics: 65 Posts: 358
your guess is absolutely right
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tolito
| Forum Junior Topics: 119 Posts: 2136
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 Topics: 9 Posts: 70
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  Topics: 468 Posts: 5028
aspirin and excercise, stop smoking, control HPand Dm
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chinda11
| Forum Junior Topics: 17 Posts: 46
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 Newbie  Topics: 42 Posts: 635
Actually it is aspirin and exercise and then it would be angiography. Surgery if possible would be after angiogram.
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chemamr
| Forum Hero  Topics: 340 Posts: 4448
ASA, exercise and stop smoking
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saadtazjam
| Forum Senior Topics: 9 Posts: 164
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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