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PVD – Peripheral Vascular Disease

Peripheral arterial disease.
By: Salameh MJ, Ratchford EV.
Vascular disease patient information page: Peripheral artery disease.
By: Ratchford EV, Evans NS.

Peripheral artery disease is common, and the symptoms typically include leg discomfort with exercise. Patients with PAD can also have other symptoms such as non-healing wounds on the feet. A simple ABI test with a blood pressure cuff can diagnose PAD. Treatment for PAD includes smoking cessation, medications aimed at preventing heart attack and stroke, and exercise to alleviate the discomfort. Patients with more severe PAD, such as those with wounds that are not healing or those with symptoms that do not respond to medication and exercise, may need to undergo a procedure to restore blood flow to the leg (angioplasty or bypass surgery).

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Vascular disease patient information page: Venous Thromboembolism (deep vein thrombosis and pulmonary embolism).
By: Evans NS, Ratchford EV.

Venous thromboembolism is common, occurring in about one to two per 1000 people each year. DVT is typically diagnosed using ultrasound. PE is usually diagnosed using a CT scan. Anticoagulant medications are the mainstay of treatment; most patients take anticoagulants for a minimum of 3 months. Several important measures can help prevent venous thromboembolism.

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ABI and stroke: action at a distance and a call to action.
By: McEvoy JW, Nasir K.
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Extensive bilateral lower extremity deep venous thrombosis in a patient on dimethyl fumarate.
By: Ratchford EV, Baldanza JT, Pardo CA.

We report a case of extensive bilateral lower extremity deep vein thrombosis (DVTs) in a patient recently started on dimethyl fumarate.

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Screening low-risk individuals for coronary artery disease.
By: Desai CS, Blumenthal RS, Greenland P.
Data regarding the role of additional testing in low-risk populations to improve early detection or to enhance risk assessment indicate that CAC and the ankle-brachial index (ABI) may be helpful for improving risk classification and detecting the higher-risk people from among those at lower risk.
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Peripheral Artery Disease.
By: Salameh MJ, Ratchford EV.
International ABI awareness as the next step in the PAD campaign.
By: Ratchford E.

Study investigates several issues related to peripheral artery disease (PAD) awareness among general practitioners (GPs) in Queensland. She contends that the study's response rate was low at 26%, however, it clearly highlights the importance of disseminating PAD guidelines and improving ankle-brachial index (ABI) awareness. She notes that the study distinguishes between PAD screening and PAD diagnosis.

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Coronary artery disease is under-diagnosed and under-treated in advanced lung disease.
By: Reed RM, Eberlein M, Girgis RE, Hashmi S, Iacono A, Jones SP, Netzer G, Scharf S.

Coronary artery disease is a potentially treatable comorbidity observed frequently in both chronic obstructive pulmonary disease and interstitial lung disease. The prevalence of angiographically proven coronary artery disease in advanced lung disease is not well described. We sought to characterize the treatment patterns of coronary artery disease complicating advanced lung disease and to describe the frequency of occult coronary artery disease in this population. Coronary artery disease is common in patients with advanced lung disease attributable to chronic obstructive pulmonary disease or interstitial lung disease and is under-diagnosed. Guideline-recommended cardioprotective medications are suboptimally utilized in this population.

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Exercise for restoring health and preventing vascular disease.
By: Stewart KJ, Ratchford EV, Williams MA.
Individuals with heart disease can benefit greatly from exercise training and other aspects of cardiac rehabilitation and secondary prevention programs. Exercise training plays a critical role as a primary treatment of patients with peripheral arterial disease, with the goal of improving quality of life and functional capacity.