Ask the expert: assessment of peripheral vascular disease in primary care

What you need to knowDiagnosis of peripheral arterial disease is based on a history of symptoms of claudication or rest pain, absent peripheral pulses, and a reduced ankle brachial pressure index (ABPI)Around 70% to 80% of patients with leg ulcers have venous disease, which can be diagnosed clinicallyPatients with vascular claudication often have a reduction in ABPI, whereas ABPI may be normal (above 1.0) in patients with spinal claudicationRefer patients who have rest pain along with clinical evidence of peripheral arterial disease with absent pulses and a reduced ABPI urgently to a vascular unit.Vascular specialists Clifford Shearman and Kosmas Paraskevas provide expert answers to questions from users of BMJ Learning on how to diagnose and assess peripheral vascular disease, both arterial and venous, in primary care.Test yourselfYou see a 54 year old man in your GP clinic. He is obese (BMI 32 kg/m2) and smokes. Three days ago, he noticed…
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