Cardiovascular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This young lady has presented with intermittent pain of the right hand. Examination of the affected limb shows all peripheral pulses to be absent and the blood pressure to be unrecordable - suggesting that the pain is due to claudication. Additionally, the presence of a subclavian bruit in the contralateral limb suggests a bilateral pathology.\n\nIn addition, she is underweight and looks ill, and has a significantly raised ESR - these features are strongly suggestive of a systemic illness.\n\nIn a patient of this age, the most likely cause for a pulseless upper limb is a large vessel arteriopathy - which may be inflammatory (i.e. a large vessel vasculitis) or non inflammatory in origin.\n\nCervical ribs may compress the subclavian artery causing "}]}

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