Dr. Usman's Cardiology Notes

A 60 year old male diabetic presented with resting limb pain for last 3 days. He has history of intermittent claudication for last 4 years and was compliant to his medications and regular exercise. On examination he has elevation limb pallor with decrease capillary refill on attaining supine position. No skin discoloration and pulses are week but palpable. One year ago his pre and post exercise ABI was 0.6. He is currently on ASA 75mg OD, atorvastatin 10mg HS, cilostazole 100mg BD and Metformin 1G BD. Please provide relevant answers: a) What was the purpose of giving ASA and Cilostazole b) His Digital extraction angiography showed critical disease in superficial femoral artery and popliteal artery. When will you consider him for revascularization and what modality will you choose? c) When will you follow your patient after successful revascularization? d) What non-invasive test will you order apart from history and physical examination in surveillance program? Answers: a)   ...

A 58 year male diabetic, hypertensive and smoker presented for executive checkup in cardiology clinic. He is asymptomatic except for feeling fatigue enough to walk >200 m. His physical examination was normal. You ordered baseline tests including lipid profile. All labs are normal except for elevated cholesterol and LDL. His ECG was normal. Please answer following questions based on guidelines a.       When should we expect PAD? b.       You screened with ABI and it turn out to be 1.29. Will you stop evaluating him or proceed for another test c.        How would you differentiate pseudoclaudication from arterial claudication? d.       How would you classify this patient based on fontaine classification Answers: a.       1)All patients above 70 years of age , 2) Between 50-70years with additional factors like DM, Smoking, 3)Any age with symptom of claudicati...