Today we're going to look at PAD versus PVD. So many students get confused with this. Peripheral vascular disease is an umbrella term for PVD and PAD.
PVD is peripheral venous disease and PAD is peripheral arterial disease. We have a venous problem and an arterial issue. I'm a visual learner so this graph helps me remember all the different signs and symptoms seen in PAD and PVD. First let's look at PAD. Remember this is an arterial issue.
We know arteries bring blood away from the heart. You can remember this by thinking A, think away. So normally oxygenated blood is being brought away from the heart and is being brought to the extremities by the arteries. Let's say for this example our circle is our foot.
But in PAD blood can't get to the extremities. This could be due to plaque buildup causing a narrow artery. So if blood can't get to the foot, that means oxygen isn't getting to the foot either.
So what signs and symptoms will we see with knowing that information? Will they have pain? Yes, they will have sharp pain that gets worse at night.
This is called rest pain. Because they are elevating their feet, which means they're impeding more blood flow to getting to the foot. They will also have something called intermittent claudation and this is pain that only occurs with activity.
How about their pulses? Are they gonna have pulses? Well, of course, they're gonna have pulses.
Their heart is still beating but in the extremities, it's going to be very weak. This is because remember it's a perfusion issue. You might even see an absent pulse in the extremities, which would be considered a medical emergency, but it can be seen in PAD.
How about edema? Well no, these patients won't really have edema because there isn't any blood in the extremity. As for the temperature, it's important to remember that blood is warm.
So no blood flow to the foot means that we're going to have a cold foot. As for the color, it's going to be the same issue. No oxygen-rich blood is being brought to the extremities. So we're going to see a pale foot because it's a perfusion issue. The skin also isn't getting the nutrient it needs.
to grow and flourish. So you're going to see a hairless, dry, scaly, very thin skin. As for the wounds, these are going to be regular in shape.
They're going to be a round appearance. We call this a punched out appearance. They're going to be also red sores.
You may see some black in the foot and this is called gangrene. This is a type of tissue death caused by lack of blood supply. And that's our issue here, lack of blood supply.
As for the treatment of PAD, we want to dangle the arteries. Think A in dangle. We want to dangle to get all that blood flowing down to the extremities.
Now let's look at PVD. We have no trouble in PVD of blood getting to the extremities. This is an issue with the vein, so blood can't get back to the heart.
This causes pooling of blood in the extremities, in this case our foot, our circle. Well, will they have pain? Well yes they'll have pain but it's not going to be intense pain like seen in PAD. It's going to be more of a dull constant achy pain. How about their pulses?
Yes these people are going to have a pulse. You may not be able to feel it because of the amount of edema. So in this case you want to get a Doppler ultrasound to hear that pulse. Like I said they're going to have so much edema.
Remember there is so much pooling of blood in that leg. As for the temperature, remember when I said blood is warm? Well, we have a lot of blood in the foot, so we're going to see a warm leg.
As for the color, we call this stasis dermatitis, and this is like a browning, yellowish coloration because of the blood pooling in there. I think of a bruise. When you get a bruise, you have a lot of pooling in that area, which causes a browning, yellowish appearance.
As for the wounds, we call this venous stasis ulcers. Stasis means the blood is staying there, and that's our issue here. The wounds are going to be irregular shaped wounds.
They're going to be shallow. Are we going to see gangrene in these patients? Well, no, because lack of blood flow is not the issue here.
We have a lot of pooling of blood in there. As for the positioning of these patients, it's opposite of PAD. We want to elevate the veins. You can think of this as a V looks like elevating. We want to get that blood back to the heart.
There are some positions that make PVD worse. Things like dangling the feet over the bed, right? sitting and standing for long periods of time.
This only worsens the pooling of blood being down to the extremities. That's all for PAD versus PVD. If you want to grab this PAD versus PVD cheat sheet, you can find it in the description below.