Data gathering
- Red flags – rest pain, colour changes in foot, calf swelling, leg numbness, night pain
- Others – exercise tolerance
- Examine – BP, pulse, BMI, CV, leg (temp/colour/pulses/skin)
Clinical management
- Investigations
- Bloods – FBC, U+Es, cholesterol, HbA1c
- ECG
- ABPI
- Doppler
- Explanation
- narrowing of arteries that supply blood to legs – due to fatty plaques developing on inside lining
- Treatment
- Lifestyle – stop smoking, exercise, weight loss, reduce alcohol intake
- Footcare – regular self inspection +- podiatry
- Medications – clopidogrel/statins
- Follow-up / Safety net – Refer to vascular if – rest pain, absent foot pulses, pallor or evidence of gangrene
NB:
- Critical ischaemia = rest pain, absent foot pulses, impaired wound healing, ABPI <0.5
- Acute ischaemic limb – pale, pain, pulseless, paralysis, paraesthesia, perishingly cold