Investigations
Explore the reasons why the following investigations might be carried out.
ECG
To diagnose atrial fibrillation or other cardiac arrhythmias or an acute cardiac event, which may be a source of emboli.
Bloods
Blood tests for acute limb ischaemia
| Investigation | Reason for investigation |
|---|---|
| Full blood count | To detect haematological disorders predisposing to thrombosis |
| U&E | Patients are often dehydratedPotassium may be raised if muscle necrosis has occurred |
| Glucose | To screen for diabetes |
| Creatinine kinase | May be raised if muscle ischaemia has occurred |
| Clotting | It is rare to detect clotting abnormalities but it is usual to check before prescribing heparin |
| Group and save | Patient may undergo surgery |
Blood gas
To look for acidosis secondary to ischaemia.
If the patient is acidotic the most important initial management is rehydration.
Imaging
The urgency of imaging depends on the presentation. Conventional imaging consists of a digital subtraction angiogram. This is an invasive procedure using intra-arterial contrast but has the potential for therapeutic intervention (thrombolysis, angioplasty).
MR angiography and CT angiography are less invasive and should provide the same anatomical information. Arterial duplex is non-invasive but is operator dependent and iliac and calf vessels can be difficult to image. The choice of imaging is likely to depend on the local resources available.