Peripheral arterial disease - Identification and implications

被引:146
作者
Mohler, ER [1 ]
机构
[1] Univ Penn, Sch Med, Presbyterian Med Ctr, Philadelphia Heart Inst,Dept Med,Cardiovasc Div, Philadelphia, PA 19104 USA
关键词
D O I
10.1001/archinte.163.19.2306
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Peripheral arterial disease (PAD) is most commonly a manifestation of systemic atherosclerosis in which the arterial lumen of the lower extremities becomes progressively occluded by atherosclerotic plaque. Patients with PAD are at triple the risk of all-cause mortality and at more than 6 times the risk of death from coronary heart disease as those without the disease, yet PAD is probably the most underdiagnosed and least aggressively managed atherosclerotic disease. In the diagnosis of PAD, a detailed history and physical examination are extremely important, although limited by a lack of consistent sensitivity and specificity. Other office-based noninvasive tests, including the ankle-brachial index, can be easily performed to confirm the diagnosis and help stratify the risk. The ankle-brachial index correlates well with disease severity and functional symptoms and can also be used to assess disease progression and to predict cardiovascular and cerebrovascular mortality. Once diagnosed, risk factor modification, symptomatic relief, and secondary prevention strategies with antiplatelet agents form the core of medical management of PAD.
引用
收藏
页码:2306 / 2314
页数:9
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