Podcast
Questions and Answers
Which of the following is the primary cause of Peripheral Arterial Disease (PAD)?
Which of the following is the primary cause of Peripheral Arterial Disease (PAD)?
What percentage of middle-aged people with PAD typically show symptoms?
What percentage of middle-aged people with PAD typically show symptoms?
What level of arterial diameter reduction is required to cause a reduction in blood flow at rest?
What level of arterial diameter reduction is required to cause a reduction in blood flow at rest?
Which of the following is typically secondary to atrial fibrillation?
Which of the following is typically secondary to atrial fibrillation?
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Which of the following conditions describes the occlusion of a major artery previously healthy and non-collateralised?
Which of the following conditions describes the occlusion of a major artery previously healthy and non-collateralised?
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Which symptoms are examples of atheroembolic events?
Which symptoms are examples of atheroembolic events?
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Study Notes
Epidemiology of PAD
- Approximately 20% of middle-aged people have Peripheral Arterial Disease (PAD), but only one-quarter of these individuals will have symptoms.
Pathophysiology of PAD
- Most cases of PAD are due to atherosclerosis.
- The risk factors for PAD are similar to those for coronary artery disease, including smoking, diabetes, hyperlipidaemia, and hypertension.
- Plaque rupture is responsible for the most serious manifestations of PAD, often occurring in asymptomatic plaques.
Mechanism of Injury
Haemodynamic
- A 70% reduction in arterial diameter (critical stenosis) is required to reduce flow at rest.
- Less severe stenosis may become critical during exertion (e.g., walking).
- Haemodynamic injury has a relatively benign course due to collateralisation.
Thrombotic
- Occlusion of a long-standing critical stenosis may be asymptomatic due to collateralisation.
- Acute rupture and thrombosis of a non-haemodynamically significant plaque usually has severe consequences.
Atheroembolic
- Symptoms depend on embolic load and size.
- Examples include carotid disease (TIA or stroke) and peripheral arterial disease (blue toe/finger syndrome).
Thromboembolic
- Usually secondary to atrial fibrillation.
- Thromboembolic injury has dramatic consequences due to the large thrombus load, which often occludes a major, previously healthy, non-collateralised artery suddenly and completely.
Clinical Features
- Clinical manifestations depend on the anatomical site.
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Description
Test your knowledge of Peripheral Arterial Disease (PAD), its causes, symptoms, and risk factors. Learn about the prevalence of PAD in middle-aged people and its relation to atherosclerosis and coronary artery disease.
