eMedicine Specialties > Emergency Medicine > Cardiovascular

Peripheral Vascular Disease: Follow-up

Author: Everett Stephens, MD, Assistant Clinical Professor, Department of Emergency Medicine, University of Louisville
Contributor Information and Disclosures

Updated: Jan 5, 2009

Follow-up

Further Outpatient Care

  • Patients who have significant peripheral vascular disease but whose illness is not so severe or acute that it requires inpatient treatment may be discharged with appropriate follow-up. However, counsel these patients regarding the potential effects of various activities and medications on the course of their illness. Advise patients to stop smoking and to avoid cold exposures and medications that can lead to vasoconstriction, including medications used for migraines and over-the-counter medications.
  • Some recreational drugs (eg, cocaine) may have a deleterious effect on peripheral arterial tone, and beta-blockers may exacerbate the condition.
  • Consultation with providers who will be following the patient after ED discharge is advised when making decisions regarding the discontinuation of medications used for chronic medical conditions.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize severe arterial insufficiency may put the patient at risk for serious local ischemic complications. In addition, it is critical that the patient be evaluated for acute cardiac conditions that might have led to peripheral arterial ischemia. Potentially significant legal consequences may ensue if these conditions are missed.
 


More on Peripheral Vascular Disease

Overview: Peripheral Vascular Disease
Differential Diagnoses & Workup: Peripheral Vascular Disease
Treatment & Medication: Peripheral Vascular Disease
Follow-up: Peripheral Vascular Disease
References
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References

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  3. McDermott MM, Liu K, Ferrucci L, et al. Circulating blood markers and functional impairment in peripheral arterial disease. J Am Geriatr Soc. Aug 2008;56(8):1504-10. [Medline].

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  5. Criqui MH, Ninomiya JK, Wingard DL, et al. Progression of peripheral arterial disease predicts cardiovascular disease morbidity and mortality. J Am Coll Cardiol. Nov 18 2008;52(21):1736-42. [Medline].

  6. Aufderheide TP. Peripheral arteriovascular disease. In: Emergency Medicine: Concepts and Clinical Practice. 1998:1826-44.

  7. Feldman AJ. Acute extremity ischemia and thrombophlebitis. In: Emergency Medicine: A Comprehensive Study Guide. 1996:389-94.

  8. Hauser CJ, Klein SR, Mehringer CM, et al. Superiority of transcutaneous oximetry in noninvasive vascular diagnosis in patients with diabetes. Arch Surg. Jun 1984;119(6):690-4. [Medline].

  9. Hedin U, Wahlberg E. Gene therapy and vascular disease: potential applications in vascular surgery. Eur J Vasc Endovasc Surg. Feb 1997;13(2):101-11. [Medline].

  10. Henein MY, Anagnostopoulos C, Das SK, et al. Left ventricular long axis disturbances as predictors for thallium perfusion defects in patients with known peripheral vascular disease. Heart. Mar 1998;79(3):295-300. [Medline].

  11. Howell JM. Acquired diseases of the arteries and veins. In: Emergency Medicine. 1998:203-6.

  12. Levien DH. Vascular surgery. In: Introduction to Surgery. 2nd ed. 1993:208-14.

  13. Schwartz GR. Nontraumatic organ system emergencies. In: Principles and Practice of Emergency Medicine. 1992:1382-90.

  14. Semashko DC. Vascular emergencies. Mt Sinai J Med. Sep-Oct 1997;64(4-5):316-22. [Medline].

  15. Yousuf AM, Pai NB. Noninvasive evaluation of vascular diseases. Hosp Physician. Apr 1991;48-52.

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Further Reading

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Keywords

PVD, peripheral vascular disease, arteriosclerosis obliterans, circulation disorder, functional peripheral vascular disease, organic peripheral vascular diseases, atherosclerosis, emboli, thrombi, atheroma, vascular disease, cardiac emboli, coronary artery disease, myocardial infarction, MI, atrial fibrillation, transient ischemic attack, stroke, renal disease, smoking, hyperlipidemia, diabetes mellitus, hyperviscosity, phlebitis, autoimmune disease, vasculitides, arthritis, coagulopathy

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Contributor Information and Disclosures

Author

Everett Stephens, MD, Assistant Clinical Professor, Department of Emergency Medicine, University of Louisville
Everett Stephens, MD is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

David A Peak, MD, Assistant Residency Director of Harvard Affiliated Emergency Medicine Residency, Attending Physician, Massachusetts General Hospital; Consulting Staff, Department of Hyperbaric Medicine, Massachusetts Eye and Ear Infirmary
David A Peak, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Gary Setnik, MD, Chair, Department of Emergency Medicine, Mount Auburn Hospital; Assistant Professor, Division of Emergency Medicine, Harvard Medical School
Gary Setnik, MD is a member of the following medical societies: American College of Emergency Physicians and National Association of EMS Physicians
Disclosure: Intellicare Salary Management position; South Middlesex EMS Consortium Salary Management position

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

David FM Brown, MD, Assistant Professor, Department of Medicine, Division of Emergency Medicine, Harvard Medical School; Associate-Chief, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital
David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Schering  Honoraria Speaking and teaching

 
 
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