Page 46 - Clinical Pearls in Cardiology

34 Clinical Pearls in Cardiology

• Capillary refill time is measured by depressing the nail
bed of a finger or toe until the underlying skin blanches.
The refill time is normal if the capillary vessels refill
within 3 seconds after pressure is released.
8. What are the 7 P’s that define the important clinical
features of limb ischemia due to acute arterial
occlusion?
Acute arterial occlusion is a sudden event that interrupts
arterial blood flow to the affected tissues or organ. Most
acute arterial occlusions are the result of an embolus
or a thrombus. The seven P’s that define the clinical
symptoms and signs that suggest acute severe limb
ischemia include the following:
7 P’s
1. Pistol shot (i.e. Acute in onset)
2. Pain
3. Pulselessness
4. Pallor
5. Paresthesias
6. Paralysis
7. Polar (i.e. cold).
9. What are the common skin changes seen in a patient
with peripheral arterial disease?
Trophic skin changes are common in patients with
peripheral arterial disease. The important trophic skin
manifestations include the following:
• Dry and scaly skin
• Brittle nails
• Alopecia or hair loss
Pallor, coolness and dependent rubor (i.e skin
becoming deep red when the leg is in the dependent
position) are the other important dermatological