HTHSCI 1DT3 Lecture Notes - Lecture 17: Intermittent Claudication, Bypass Surgery, Calcification

• School: McMaster University
• Department: Health Sciences
• Course: HTHSCI 1DT3
• Professor: Carl Richards

Document Summary

5% of males >50yrs have intermittent claudication. Persistent rest pain requiring analgesia for 2wks. Typically asymptomatic until 50% stenosis (vasculitis and fibromuscular dysplasia are v. rare causes) Atherosclerosis summary: endothelial injury: haemodynamic, htn, lipids, chronic inflammation. Lymphocyte and smc recruitment: sm proliferation: conversion of fatty streak to atherosclerotic plaque. Atherosclerosis = arterial hardening specifically due to atheroma. Necrotic centre: cell debris, cholesterol, ca, foam cells. Cramping pain after walking a fixed distance. Calf pain = superficial femoral disease (commonest) Buttock pain = iliac disease (internal or common) Due to co and loss of gravity help. Atherosclerotic occlusion of abdominal aorta and iliacs. Acute inflammation and thrombosis of arteries and veins in the hands and feet ulceration and gangrene. Pulses: pulses and crt (norm 2sec) Reactive hyperaemia due to accumulation of deoxygenated blood in dilated capillaries. Fontaine: asympto (subclinical, intermittent claudication, >200m, <200m, ischaemic rest pain, ulceration / gangrene.