CVA patient with unpalpable pulse!!

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Hello fellow podiatrists!
I have recently seen a 75yr old female exsmoker of 5yrs in my clinic with a history of TIA's and a CVA. Her DP and PT are monophasic on the left but the Right DP is weak and thready and the PT is not palpable. Her CVA has affected the right side of her body with the Right foot being plantarflexed with circumducted gait. She also has an ulcer on her Right 5th IPJ which i am treating. I have considered atherosclerosis due to the smoking however am unsure whether this would cause unilateral absent pulses. However any imput into why the pulses are worse on the CVA affected side would be appreciated!!!

 

Just co-incidence.

The fact this person has had a CVA proves also that they have generalised PAD.

As the lumen narrows due to atherosclerosis, it may affect one leg/carotid more than the other. Just plain luck as to which is the worst.

So you can be fairly sure, in the abscence of PN that you are treating an ischaemic ulcer, so do so accordingly.

LL

 

Why not ask a senior member of staff ???
2 posts in 2 days ???
Seems your looking for differential diagnosis ???
Maybe a

 

Hi New Qual Pod,

How about a brief introduction of yourself to the Podiatry Arena Members?

Some people tend to respond more courteously when they have an idea who they are conversing with, and what your interests are.

BTW Dermot, we cannot assume that this poster has any back-up or senior colleagues to ask. Don't we all know some horror stories of NHS and Private sector work, where you are dumped in the middle of nowhere with no-one to help.