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"Poor Circulation" or Peripheral Vascular Disease (P.V.D) may be noted from palpating the pulses, listening to the pulse via a Doppler and assessing the colour, and texture of the skin along with its visual properties. 
Skin lesions such as chilblains often present in colder weather, with further ulceration in the patient with P.V.D. 

The importance of understanding the effects of arterial blockages, and P.V.D in feet was highlighted during winter 2011, when two patients were assessed and immediately referred back to their G.P.'s with letters requesting further vascular checks, and recommending intervention by a Vascular Consultant. 

Luckily the GP reacted quickly and one the patient attended for surgery for an urgent  heart valve replacement.

The assessments were responsible for initiating critical and potentially life saving intervention in both these cases, but very minor changes to medication or lifestyle advice can make a huge difference to vascular wellbeing. 


N.I.C.E. guidelines in the UK recommend that heavy smokers, Diabetic and patients with Raynauds syndrome see a State Registered Podiatrist for annual foot checks.