Question

Read the clinical scenario and answer the questions to explore your understanding of cardiac pathophysiology. Mr. W., a 57-year-old nurse, developed crushing substernal chest pain with dyspnea, dizziness, and nausea while trying to lift a patient from a bed to a chair. In the emergency department, he states that his symptoms resolved as soon as he sat down to rest. Mr. W indicates that he has had similar episodes in the past, particularly when trying to do strenuous yard work. After an ECG and other tests, his diagnosis is stable angina. 19. Why is it important to examine the appearance of Mr. W's lower extremities and palpate his pedal pulses?

Answer 1

Mr. W is an elderly man and he is diagnosed as stable angina.This angina is a warning sign for PAD(Pheripheral Artery Disease) the leading cause of death in US.Diminished or absent pedal pulse is the most reliable finding for a patient having peripheral vascular disease.patients are normally screened with ankle-brachial index (ABI) measurement of one both extremities.Low ABI ratio is an independant risk factor for cardiovascular disease.The diminished blood supply to the lower limbs contribute skin changes in patients with PAD.skin manifestations includea change in skin colour,cold,dry and atropic skin,loss of hair,dystrophic nail changes and fissures.Ultimate limb loss also seen in PAD.