Assignment: Peripheral Vascular Disease Case Studies

Want create site? With you can do it easy.

Assignment: Peripheral Vascular Disease Case Studies

Assignment: Peripheral Vascular Disease Case Studies

A 52-year-old man complained of pain and cramping in his right calf caused by walking two

blocks. The pain was relieved with cessation of activity. The pain had been increasing in

frequency and intensity. Physical examination findings were essentially normal except for

decreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibial

pulses were markedly decreased compared with those of his left leg.

Studies Results

Routine laboratory work Within normal limits (WNL)

Doppler ultrasound systolic pressures Femoral: 130 mm Hg; popliteal: 90 mm Hg;

posterior tibial: 88 mm Hg; dorsalis pedis: 88

mm Hg (normal: same as brachial systolic

blood pressure)

Arterial plethysmography Decreased amplitude of distal femoral, popliteal,

dorsalis pedis, and posterior tibial pulse waves

Femoral arteriography of right leg Obstruction of the femoral artery at the midthigh


Arterial duplex scan Apparent arterial obstruction in the superficial

femoral artery

Diagnostic Analysis

With the clinical picture of classic intermittent claudication, the noninvasive Doppler and

plethysmographic arterial vascular study merely documented the presence and location of the

arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography

to document the location of the vascular occlusion. The patient underwent a bypass from the

proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.

Critical Thinking Questions

1. What was the cause of this patient’s pain and cramping? 2. Why was there decreased hair on the patient’s right leg? 3. What would be the strategic physical assessments after surgery to determine the

adequacy of the patient’s circulation?

4. What would be the treatment of intermittent Claudication for non-occlusion?

Case 1: Peripheral Arterial Disease That Is Getting Worse 
Despite Medical Intervention,
65-year-old man was admitted to the clinic after experiencing deterioration of acute left calf pain and decrease in activity tolerance as result of the pain. 
The patient reported occasional left calf pain for three months and denied any injuries, back pain, fever, or limb weakness. 
The medical history, on the other hand, was significant for hyperlipidemia. 
He was former smoker who had quit months prior; nonetheless, he had been smoking pack of cigarettes day for the previous 40 years. 
The patient denied drinking or using recreational drugs. 
Low-dose aspirin and high-intensity atorvastatin were his meds. 
Vital signs were normal on physical examination. 
The BMI was 28 kg/m2 (body mass index). 
Femoral pulses were reduced on both sides. 
Pulses in the popliteal, right dorsalis pedis, and right posterior tibialis were all weak. 
Pulses in the left dorsalis pedis and posterior tibialis could not be felt. 
The results of the cardiac check were normal. 
The physical examination was otherwise ordinary. 
On the left, the ankle-brachial index was 0.67, while on the right, it was 0.91. 
He had been involved in supervised exercise program for three months, but despite strict devotion to the program, the patient’s symptoms worsened. 
How would you handle this situation?


Review of the Situation


Despite initial medical therapy, patient with increasing peripheral arterial disease (PAD) is depicted in this scenario. 
Progressive PAD is characterized by progressive decrease in exercise tolerance due to worsening left leg pain and nonpalpable dorsalis pedis and posterior tibialis pulse on the left side on physical examination. 
The patient is already receiving basic medical treatment for PAD, which includes quitting smoking, taking aspirin, taking high-intensity statins, and participating in supervised exercise program.


Discussion of the Case


The aortic bifurcation and arteries of the lower limbs, such as the iliac, femoral, popliteal, and tibial arteries, are most typically narrowed in PAD. 
The most common cause is atherosclerosis. 
Smoking (current or previous), diabetes mellitus, and advancing age are all risk factors for PAD. 
Ischemic events, such as myocardial infarction, stroke, and cardiovascular mortality, are more common in patients with PAD. 
Patients with atypical limb symptoms (eg, leg weakness, paresthesia), exertional leg discomfort, and/or nonhealing ulcers who have atherosclerotic risk factors (smoking, diabetes, hypertension, dyslipidemia, and advanced age) should have their ankle-brachial index (ABI) measured first.


Symptoms in the Clinic


Because lower extremity PAD is characterized by an abnormal ABI value rather than symptoms, there is wide range of clinical presentations. 
Patients may experience intermittent claudication (exertional leg pain relieved by rest), unusual exertional leg pain, rest pain, nonhealing wounds, ischemic ulcers, or gangrene.


The following is the ABI interpretation:


Severe PAD (ABI 0.00 to 0.40)


Mild to moderate PAD with an ABI of 0.41 to 0.90.


ABI 0.91 to 0.99: PAD on the edge


ABI 1.00-1.40: Average


Noncompressible (ABI >1.40)
Did you find apk for android? You can find new and apps.

What Will You Get?

We provide professional writing services to help you score straight A’s by submitting custom written assignments that mirror your guidelines.

Premium Quality

Get result-oriented writing and never worry about grades anymore. We follow the highest quality standards to make sure that you get perfect assignments.

Experienced Writers

Our writers have experience in dealing with papers of every educational level. You can surely rely on the expertise of our qualified professionals.

On-Time Delivery

Your deadline is our threshold for success and we take it very seriously. We make sure you receive your papers before your predefined time.

24/7 Customer Support

Someone from our customer support team is always here to respond to your questions. So, hit us up if you have got any ambiguity or concern.

Complete Confidentiality

Sit back and relax while we help you out with writing your papers. We have an ultimate policy for keeping your personal and order-related details a secret.

Authentic Sources

We assure you that your document will be thoroughly checked for plagiarism and grammatical errors as we use highly authentic and licit sources.

Moneyback Guarantee

Still reluctant about placing an order? Our 100% Moneyback Guarantee backs you up on rare occasions where you aren’t satisfied with the writing.

Order Tracking

You don’t have to wait for an update for hours; you can track the progress of your order any time you want. We share the status after each step.


Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.

Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.


Trusted Partner of 9650+ Students for Writing

From brainstorming your paper's outline to perfecting its grammar, we perform every step carefully to make your paper worthy of A grade.

Preferred Writer

Hire your preferred writer anytime. Simply specify if you want your preferred expert to write your paper and we’ll make that happen.

Grammar Check Report

Get an elaborate and authentic grammar check report with your work to have the grammar goodness sealed in your document.

One Page Summary

You can purchase this feature if you want our writers to sum up your paper in the form of a concise and well-articulated summary.

Plagiarism Report

You don’t have to worry about plagiarism anymore. Get a plagiarism report to certify the uniqueness of your work.

Free Features $66FREE

  • Most Qualified Writer $10FREE
  • Plagiarism Scan Report $10FREE
  • Unlimited Revisions $08FREE
  • Paper Formatting $05FREE
  • Cover Page $05FREE
  • Referencing & Bibliography $10FREE
  • Dedicated User Area $08FREE
  • 24/7 Order Tracking $05FREE
  • Periodic Email Alerts $05FREE

Our Services

Join us for the best experience while seeking writing assistance in your college life. A good grade is all you need to boost up your academic excellence and we are all about it.

  • On-time Delivery
  • 24/7 Order Tracking
  • Access to Authentic Sources
Academic Writing

We create perfect papers according to the guidelines.

Professional Editing

We seamlessly edit out errors from your papers.

Thorough Proofreading

We thoroughly read your final draft to identify errors.


Delegate Your Challenging Writing Tasks to Experienced Professionals

Work with ultimate peace of mind because we ensure that your academic work is our responsibility and your grades are a top concern for us!

Check Out Our Sample Work

Dedication. Quality. Commitment. Punctuality


It May Not Be Much, but It’s Honest Work!

Here is what we have achieved so far. These numbers are evidence that we go the extra mile to make your college journey successful.


Happy Clients


Words Written This Week


Ongoing Orders


Customer Satisfaction Rate

Process as Fine as Brewed Coffee

We have the most intuitive and minimalistic process so that you can easily place an order. Just follow a few steps to unlock success.

See How We Helped 9000+ Students Achieve Success


We Analyze Your Problem and Offer Customized Writing

We understand your guidelines first before delivering any writing service. You can discuss your writing needs and we will have them evaluated by our dedicated team.

  • Clear elicitation of your requirements.
  • Customized writing as per your needs.

We Mirror Your Guidelines to Deliver Quality Services

We write your papers in a standardized way. We complete your work in such a way that it turns out to be a perfect description of your guidelines.

  • Proactive analysis of your writing.
  • Active communication to understand requirements.

We Handle Your Writing Tasks to Ensure Excellent Grades

We promise you excellent grades and academic excellence that you always longed for. Our writers stay in touch with you via email.

  • Thorough research and analysis for every order.
  • Deliverance of reliable writing service to improve your grades.
Place an Order Start Chat Now