Ischaemic heart disease

Ischaemic heart disease is arguably the most important complication of diabetes. It is certainly the leading cause of premature mortality amongst people with T2DM and cardiovascular risk modification is one of the most important goals of diabetes treatment.

General examination

A thorough general and systems examination is an essential part of the assessment of any patient with a diabetes complication.

Cardiovascular

Assess the patient for any signs of cardiac failure, which may be due to previous myocardial infarction.

Pedal

Are the peripheral pulses palpable? Atherosclerotic disease in any part of the arterial tree increases chances of coronary atheroma.

Abdominal

The abdominal aorta should be palpated to seeks signs of abdominal aortic aneurysm.

Examine the entire arterial tree

The presence or absence of all arterial pulses should be documented i.e. the radial, brachial, carotid, femoral, popliteal, dorsalis pedis and posterior tibial. In addition, carotid, renal and femoral arteries should be auscultated for presence of arterial bruits.

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