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Perifer arteriell sykdom

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Definisjon: 
Perifer arteriell sykdom er aterosklerose i ikke-kardiale blodkar, og omfatter asymptomatisk aterosklerose, klaudikatio intermittens (PAD), kronisk kritisk ekstremitetsiskemi og akutt iskemi - dette dokumentet omhandler PAD
Forekomst:
Hyppighet øker med alder: 2% i aldergruppen over 50 år, 20% i aldersgruppen over 75 år.
Symptomer:
Hovedplagen ved klaudikatio er smerter i legg eller lår ved fysisk anstrengelse, bedring i hvile.
Funn:
Ved undersøkelse ev. svekket perifer puls, stenose-lyder i bekken/lyske. Etter hvert kalde ekstremiteter, trofiske forandringer i huden, økt risiko for sårdannelse.
Diagnostikk:
Diagnosen bekreftes ved blodtrykksmåling: Ankel-arm indeks < 0,9
Behandling:
Konservativ behandling, røykeslutt viktigst. Hyppig mosjon. Angioplastikk (blokking), ev. bypass kirurgi dersom konservativ behandling ikke er tilstrekkelig. Statiner, platehemmer og ev. blodtrykksbehandling for å bremse progresjon, og som profylakse mot annen hjerte-kar sykdom
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  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Torbjørn Dahl, overlege, kirurgisk avdeling, St. Olavs Hospital, Trondheim