Surg: Acute Limb Ischaemia: Free MSRA Podcast

🦵 MSRA Deep Dive – Peripheral Arterial Disease (PAD)Your go-to guide for everything you need to know about PAD for the MSRA. We break down the key facts, red flags, investigations, and management — all made easy to understand and remember.🔑 Key Learning Points📌 DefinitionPAD = narrowed arteries (mostly in the legs) due to atherosclerosis, reducing blood flow and oxygen delivery to tissues.📌 Risk Factors🚬 Smoking (most important modifiable risk)🩸 Diabetes, hypertension, hyperlipidaemia🎂 Age >50, sedentary lifestyle🧬 Family history🏥 Chronic kidney disease, vasculitis, coagulopathies📌 PathophysiologyAtherosclerotic plaque narrows arteries → less blood flow → ischaemia.Initially causes intermittent claudication (pain on walking), progressing to rest pain, ulcers, or gangrene in severe cases.📌 Clinical Features🦵 Intermittent claudication🦶 Rest pain, non-healing foot ulcers🧊 Cool limb, reduced/absent pulses🔍 Trophic changes: shiny skin, hair loss, pallor on elevation⚠️ Acute limb ischaemia = 6 Ps: Pain, Pallor, Pulseless, Paralysis, Paraesthesia, Perishing cold📌 DifferentialsDVT, cellulitisMusculoskeletal pain (arthritis, tendinopathy)Neurogenic pain (sciatica, spinal stenosis)Chronic venous insufficiencyDiabetic neuropathy📌 Investigations🩺 ABPI (Ankle-Brachial Pressure Index):Normal = 1.0–1.4<0.9 = PAD<0.5 = critical ischaemia🖥️ Duplex ultrasound = first-line imaging🧪 Bloods: lipids, glucose, HbA1c🧠 ECG (screen for ischaemic heart disease)📸 Angiography/CTA/MRA if revascularisation needed📌 Management✅ Conservative/Lifestyle:Stop smokingSupervised exerciseWeight loss, healthy diet✅ Medical:High-intensity statinAntiplatelet (aspirin or clopidogrel)BP & glucose control✅ Surgical:Angioplasty ± stentingBypass graftingAmputation (last resort for severe cases)⚠️ Acute limb ischaemia = emergency → heparin + urgent vascular referral📌 Prognosis & Complications🫀 PAD is a marker of systemic atherosclerosis → ↑ risk of MI, stroke, CV death🦶 Risk of ulceration, infection, gangrene, amputation📈 Poorer outcomes with diabetes, delayed treatment, or critical limb ischaemia🧠 PAD triples CV mortality risk🩸 Beware of complications from interventions (bleeding, infection, embolism)🧠 Mnemonics to Remember6 Ps = Acute ischaemia: Pain, Pallor, Pulseless, Paralysis, Paraesthesia, Perishing coldABPI <0.9 = Diagnostic of PADSMART AGE = Smoking, Male, Age, Relations (FH), Type 2 DM, HTN🎧 More MSRA Resources📝 Revision Notes: https://www.passthemsra.com/topic/peripheral-arterial-disease-acute-limb-threatening-ischaemia-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/peripheral-arterial-disease-acute-limb-threatening-ischaemia-flashcards/💬 Q&A Notes: https://www.passthemsra.com/topic/peripheral-arterial-disease-acute-limb-threatening-ischaemia-accordion-qa-notes/🚀 Quiz: https://www.passthemsra.com/topic/peripheral-arterial-disease-acute-limb-threatening-ischaemia-rapid-quiz/✅ Made for MSRA. Tailored to save time. Let’s get it done.#MSRA #PeripheralArterialDisease #PAD #MSRARevision #ABPI #IntermittentClaudication #VascularSurgery #PassTheMSRA #FreeMSRA