PAINE #PANCE Pearl – Cardiovascular



Question

74yo woman, with a history of CAD and hyperlipidemia, presents to your office with a 6-month history of leg pain and swelling. She states that it seems to be worse when she is on her feet and improves when she can put her legs up. She denies worsening pain with activity or walking, but has recently developed a “rash” on her legs that is worrying her (see below). Physical examination reveals warmth to the feet and legs with scattered, thin hair. You appreciate 1+ DP and PT pulses bilaterally.

  1. What are some bedside maneuvers or tests you can perform to differentiate between arterial and venous insufficiency?
  2. What are the findings associated with each?

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