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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...

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A peripheral artery disease screening study in Puerto Rico.

Héctor Delgado-Osorio1, Hilton Franqui-Rivera, Mario R García-Palmieri

  • 1University of Puerto Rico, Medical Sciences Campus, School of Medicine, Department of Medicine, Cardiology Section, San Juan, Puerto Rico.

Boletin De La Asociacion Medica De Puerto Rico
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Summary

Peripheral artery disease (PAD) screening in Puerto Rico found a high prevalence of 41.8%. Male gender and arterial hypertension were significantly associated with PAD, highlighting the need for early diagnosis and management.

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Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Epidemiology

Background:

  • Peripheral artery disease (PAD) of the lower extremities is often underdiagnosed and undertreated.
  • Early detection of PAD is crucial for implementing preventive and management strategies.

Purpose of the Study:

  • To present the results of peripheral artery disease (PAD) screening in adults attending outpatient clinics in Puerto Rico.
  • To estimate the prevalence of PAD and identify associated factors in the study population.

Main Methods:

  • Conducted 33 outpatient screening clinics across Puerto Rico from 2007 to 2010.
  • Screened 933 asymptomatic patients using the ankle-brachial index (ABI), with ABI < 0.9 considered positive for PAD.
  • Employed logistic regression models to assess factors associated with a positive PAD screening test.

Main Results:

  • A high prevalence of PAD was observed, with 41.8% (390 out of 933) of patients having an ABI < 0.9.
  • Male gender (OR = 1.92) and arterial hypertension (OR = 2.16) were significantly associated with PAD.
  • Clinical characteristics like leg edema, intermittent claudication, coldness, and weak pulses were more prevalent in patients with PAD.

Conclusions:

  • Arterial hypertension, cigarette smoking, diabetes mellitus, and dyslipidemia are key risk factors for PAD.
  • Physicians must prioritize early PAD diagnosis, especially in asymptomatic individuals, to initiate timely preventive and management measures.