Ischemia of lower limbs in the activity of a general practitioner — family physician: from widely spread to rare disorders (literature review with some results of the own clinical observations)

Abstract

The most common cause of ischemic disorders of the lower limbs is peripheral artery disease of atherosclerotic origin, the prevalence of which is constantly increasing. In Europe, ischemic heart disease is responsible for 20 % of men’s death and 22 % of women’s death, stroke is the cause of death in 10 % of men and 15 % of women. At the same time, other cardiovascular diseases, including peripheral artery disease, are the cause of 12 % of men’s death and 15 % of women’s death. Primary care physicians very often don’t have necessary awareness about diseases of peripheral arteries of the lower limbs in contrast to atherosclerotic lesions of coronary and cerebral vessels. Late diagnosis and lack of proper treatment result in severe complications, disability and death of such patients. The article contains literature data and current recommendations about diagnosis and treatment of the ischemic lesions of the lower limbs, namely intermittent claudication, chronic ischemia of the lower limbs with a risk of limb loss and acute ischemia of the lower limbs, which are necessary in the activity of a general practitioner — family physician. In the clinical practice, there are also cases of ischemic lesions of the limbs due to unusual and rare causes. The article contains literature data and own observations of such rare disorder, namely symmetrical peripheral gangrene.