Dr. Brittnay CAD/CVI

A 70-year-old smoker reports calf pain every time he walks two blocks. The pain goes away after resting. His feet are cool, pale, and have weak pedal pulses. What is the diagnosis?

PAD. The arteries are narrowed by plaque, so not enough oxygen-rich blood reaches the leg muscles during exercise. Rest decreases oxygen demand and relieves the pain.

A patient has shiny, hairless lower legs and diminished pedal pulses. What condition is most likely?

PAD. Poor arterial circulation causes loss of hair growth, thin shiny skin, and weak pulses because blood is not reaching the tissues adequately.

A patient has cool, pale feet and complains of leg pain when walking. Why do these findings occur?

PAD. Decreased arterial blood flow reduces oxygen delivery to the tissues, causing pallor, coolness, and claudication.

A patient has absent dorsalis pedis pulses on examination. Why is this finding associated with PAD?

Blocked arteries decrease blood flow to the lower extremities, making pedal pulses weak or absent.

A patient complains of calf pain when walking that improves with rest. What symptom is this called and why does it occur?

Intermittent claudication. Exercise increases oxygen demand, but narrowed arteries cannot deliver enough blood to the muscles.

A 68-year-old woman has chronic leg swelling that worsens throughout the day. She has varicose veins and brown discoloration around her ankles. What is the diagnosis?

CVI. Damaged venous valves allow blood to pool in the legs, causing edema and skin changes.

A patient has edema, blood pooling, and a venous ulcer near the medial malleolus. What condition is most likely?

CVI. Venous blood cannot return efficiently to the heart, leading to increased pressure, swelling, and ulcer formation.

A patient reports aching legs that improve when she elevates them. Why does elevation help?

CVI. Elevation uses gravity to assist venous return and reduce blood pooling in the legs.

A patient has brown discoloration around the ankles. Why does this occur in CVI?

Chronic venous congestion causes red blood cells to leak into tissues. Iron deposits (hemosiderin) create the brown discoloration.

A patient has a history of DVT and now has chronic lower-extremity swelling. Why is DVT a risk factor for CVI?

DVT can damage venous valves. Once the valves fail, blood pools in the legs and chronic venous insufficiency develops.

A patient has cool, pale, hairless legs with weak pulses. Why is this PAD and not CVI?

PAD is an arterial disease characterized by poor blood supply. CVI usually presents with edema, normal pulses, and blood pooling.

A patient has edema, varicose veins, and a medial ankle ulcer. Why is this CVI and not PAD?

CVI is a venous disease characterized by blood pooling and swelling. PAD typically causes cool, pale extremities with decreased pulses.

What carries blood away from the heart and why is this important in PAD?

Arteries. PAD occurs when arterial blood flow to the legs becomes blocked or narrowed.

What carries blood back to the heart and why is this important in CVI?

Veins. CVI occurs when venous blood cannot return efficiently because of damaged valves.

A patient asks why their feet are cold with PAD.

Arterial blood carries warmth and oxygen. When blood flow is reduced, the feet become cool.

A patient asks why their legs swell with CVI.

Blood pools in the veins, increasing pressure and causing fluid to leak into surrounding tissues, producing edema.