Peripheral Muscular Disease Case Studies

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1. Presentation of primary and secondary diagnosis
Primary Diagnosis: Peripheral Vascular Disease (PVD)
Normally, as the heart contracts, it is able to exert a pressure that drives blood throughout the cardiovascular system and allows for perfusion as well as gas and nutrient exchange to take place. This blood flow is typically described by the equation Q=P/R, where Q represents blood flow, P is the pressure gradient, and R stands for total peripheral resistance.1 In a well-functioning system, a general balance is maintained between the pressure and resistance, which allows blood to reach all areas of the body.
In patients with Peripheral Vascular Disease (PVD), there is a lesion that prevents the normal flow of blood to the peripheries. These lesions can be due to atherosclerosis, a thromboembolism, or vasculitis. With the presence of one or more of these factors, the lumen of the involved peripheral vessel narrows and consequently, results in a lower pressure at the distal segments. Depending on the severity of the disease, this can cause distal tissues to not be adequately perfused with blood, which can predispose these tissues to complications such as skin ulcers, gangrene, and tissue loss.2
Typically, PVD is diagnosed using the Ankle-Brachial Index (ABI), which uses either
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This is a gradual and progressive condition that is rarely caused by an infection (Greenfield 2015). Tissue ischemia may form coagulative necrosis, which is a sign for dry gangrene versus a liquefactive necrosis that indicates wet gangrene. The affected area becomes dry, cold, and eventually turns purple or black due to a lack of blood flow to that part of the body (Goodman 2015). Dry gangrene typically affects the distal extremities, thus it is usually seen at the patient’s fingers or toes. Our patient presented with dry gangrene located at his big toe on his left

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