Peripheral Vascular Disease (PVD) - Arterial and Venous Disorders

Comprehensive vocabulary flashcards covering the pathophysiology, clinical manifestations, diagnostics, interprofessional management, surgical interventions, and pharmacotherapy for peripheral arterial and venous disorders.

Peripheral Artery Disease (PAD)

A condition characterized by progressive thickening of arterial walls and narrowing of arteries in the upper and lower extremities, with atherosclerosis being the leading cause.

Intermittent Claudication

Ischemic muscle pain and nerve irritation precipitated by exercise or physical activity, relieved by rest, and reproducible; caused by anaerobic metabolism and the accumulation of metabolic wastes due to arterial obstruction.

Dependent Rubor and Elevation Pallor

Physical signs of advanced peripheral artery disease in which the extremity develops deep reddish-purple hyperemia when placed in a dependent position, and turns pale or blanched when elevated above heart level.

Critical Limb Ischemia (CLI)

An advanced stage of peripheral artery disease characterized by chronic ischemic rest pain lasting $> 2\,\text{weeks}$, non-healing arterial leg ulcers, or gangrene.

Ankle-Brachial Index (ABI)

A diagnostic screening ratio calculated as $\frac{\text{Ankle SBP}}{\text{Brachial SBP}}$; values of $\le 0.90$ indicate peripheral artery disease, while values of $0.70\text{--}0.41$ indicate moderate PAD and $\le 0.40$ represent severe PAD.

Percutaneous Transluminal Angioplasty (PTA)

A catheter-based interventional procedure in which a balloon is inflated inside an occluded artery to compress atherosclerotic plaque and widen the lumen, frequently accompanied by stent placement.

Endarterectomy

A surgical intervention involving an incision directly into an occluded artery to physically core out and remove obstructing atherosclerotic plaque from the vessel wall.

Acute Limb Ischemia (6 Ps)

A vascular medical emergency marked by the sudden interruption of arterial blood supply to an extremity, presenting with Pain, Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia.

Poikilothermia

The failure of thermal regulation in an ischemic body part, causing the limb to adapt to the ambient room temperature (feeling cold to touch); one of the 6 Ps of acute limb ischemia.

Thromboangiitis Obliterans (Buerger Disease)

A non-atherosclerotic, recurring inflammatory disorder of small and medium arteries and veins; managed definitively by complete and permanent cessation of all tobacco and marijuana use.

Raynaud's Phenomenon

An episodic vasospastic disorder affecting small cutaneous arteries in the fingers and toes, causing classic red, white, and blue triphasic color changes triggered by cold exposure, stress, tobacco, or caffeine.

Phlebitis

Acute inflammation of the wall of a small cannulated vein characterized by localized pain, tenderness, warmth, erythema, edema, and a palpable venous cord; treated by prompt catheter removal.

Virchow's Triad

The three cardinal factors responsible for thrombus formation: endothelial damage, venous stasis, and hypercoagulability of the blood.

Postthrombotic Syndrome (PTS)

A chronic complication of deep vein thrombosis caused by persistent venous hypertension and valvular damage, characterized by chronic edema, pain, heaviness, skin pigment changes, and secondary ulceration.

Warfarin (Coumadin)

An oral Vitamin K Antagonist anticoagulant that prevents clot extension and requires regular monitoring of the International Normalized Ratio (target INR $2.0\text{--}3.0$); its specific reversal agent is Vitamin K.

Unfractionated Heparin (UH)

An indirect thrombin inhibitor administered intravenously for active thrombosis or subcutaneously for prophylaxis; requires monitoring of activated partial thromboplastin time ($\text{aPTT} = 1.5\text{--}2.5 \times \text{baseline}$) and is reversed with protamine sulfate.

Heparin-Induced Thrombocytopenia (HIT)

A serious immune-mediated complication of heparin exposure characterized by a rapid drop in circulating platelet count and paradoxically increased risk of arterial and venous thrombosis.

Enoxaparin (Lovenox)

A low-molecular-weight heparin (LMWH) indirect thrombin inhibitor administered subcutaneously at least $2\,\text{inches}$ from the umbilicus without expelling the air bubble; provides a longer half-life and more predictable response than unfractionated heparin.

Greenfield Filter

An inferior vena cava interruption device placed percutaneously via the femoral or internal jugular vein to mechanically capture traveling emboli from the lower extremities without obstructing vena caval blood return.

Chronic Venous Insufficiency (CVI)

A disorder resulting from incompetent venous valves that causes retrograde venous flow, pooling, and elevated hydrostatic pressure, leading to lower leg edema, leathery brown pigmentation, eczema, and ulcerations.

Arterial Ulcer

An ischemic wound typically located on the tips of toes, feet, or lateral malleolus, featuring rounded, smooth, 'punched-out' margins, minimal wound drainage, and black eschar or pale pink granulation tissue.

Venous Ulcer

A stasis wound typically located near the medial malleolus, featuring irregular wound margins, moderate to large exudate, ruddy red granulation tissue or yellow slough, and surrounding bronze-brown hemosiderin skin pigmentation.