Question

Case Study

Mr. KIM is a 57-year-old male who consulted his physician after noticing marked leg pains while playing golf. He had previously noticed increasing fatigue and discomfort in his legs associated with moderate exercise. When sitting for extended periods with legs dangling, his legs became red, and sometimes his feet felt numb. His history indicates he smokes cigarettes and is chronically overweight. His blood cholesterol and other lipid levels are abnormal, and his physician suspects peripheral atherosclerosis is the cause of his discomfort.

1. Discuss the development of atherosclerosis, including the predisposing factors in this case and the pathophysiologic changes.
2. Discuss the complications that may develop in this case.
3. Discuss the treatments for all aspects of the patient’s condition, including slowing the progress of the atherosclerosis, maintaining circulation in the leg, and treating complications.
4. Describe ankle-brachial index (ABI)
5. Define intermittent claudication.

Answer 1

The development of atherosclerosis occur when ther is a tear in the endothelium.This can happen when there is conditions like smoking,high blood pressure and high cholestrole level in the blood.In these cases the the substances such as fat or cholestrol get build up in the wal of the artety causing the formation of plaque.This plaque can narrow the blood vessel and make the flow of blood through it reduced.Or ther will be complete block and the blood flow to the distant organ can get stopped.So althogether the development of te atherosclerosis takes include five steps.

1 Dmage to the endothelial cells

2.Accumilation of fat or chelostrol in the walls

3.Accumilation of the leukocytes in this region.

4 Plaque formation

5.Break or tear to the extracellular matrix.

In this case the oredisposing factors are smoking,high levels of cholestrol,obesity .

Pthophysiological changes The increased level of cholestrol leads to the damage of the permiability of the arterial blood vessels.Due to this the lipids get accumilated in this area mainly the LDL-C.There will be formation of the foamy macrophage due to the adhesion of the circulating macrophages adhere to the endothelial cells.By this process the plaques are formed and finally it blocks the blood vessel.

Complications of atheroscleosis are depends on which artery is affected.In this case the artery in the lower extrimity is affected so the complications that can happen are peripheral vascular disease and the aneurysms.

For slowing the pregress ask the client to quit smoking,follow healthy eating habits,regular exercise and to reduce the body weight.Also there are certain things like administering medications to reduce the cholestrol level in the blood,The important thing that we can administer to slow down the progress of the atherosclerosis is the administration of angiotensin convering enzyme inhibitor.Administration of Anti platelet medications ,and exercise can be done to increase the circulation.

Statins,vasodialators and antiplatelet drugs can be administerd to treat the complications like peripheral vascular disease and anurysm.

Ankle-brachial index (ABI) is nothing but the comparison of the blood pressure in the lower limb and the upper limb.Here the blood pressure in the artery in the ankle is devide by the blood pressure in the artery in the arm.The normal ABI index is between 0.9 and 1.30

Intermittent claudication is the pain that occurs after walking or doinmg exercise,this is because of the low blood flow to the muscles.This is known as intermittened claudication because the pain is not constant.