Core IM | Internal Medicine Podcast #165 Peripheral Arterial Disease: 5 Pearls Segment
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Nov 27, 2024 Arthi Rao, a cardiology fellow, and Eric Sosemsky, a vascular medicine cardiologist, dive deep into the complexities of peripheral arterial disease (PAD). They discuss when to suspect PAD and the critical role of the Ankle-Brachial Index (ABI) in diagnosis. The conversation highlights non-surgical management strategies, emphasizing lifestyle changes, medications like cilostazol, and cardiovascular risk management. They also outline when revascularization may be necessary and explore therapy options that can significantly improve patient quality of life.
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PAD Management
- Most PAD patients don't require revascularization with proper medical management and smoking cessation.
- Focus on intensive medical therapy and exercise to prevent limb-threatening ischemia or amputation.
Improving PAD Symptoms
- Prescribe cilostazol for symptom improvement, but be mindful of GI side effects, headaches, dizziness, and CHF contraindication.
- Supervised exercise therapy is crucial, even comparable to stents in symptom relief.
Exercise Therapy Success
- One patient couldn't walk down the hallway without claudication initially.
- After supervised exercise therapy, he was doing laps around the mall.