Liam (he/him) is 55 years old. He is a full-time bricklayer who immigrated from Scotland to Australia when he was 19. He lives with his wife Lorna in a one storey house, and together they have 3 daughters (all have moved out of home). Four months ago Liam underwent a right below knee amputation due to peripheral vascular disease and has given up working. Prior to his operation, he was smoking a pack of cigarettes per day (40/day), and now reduced to 25/day. Liam now spends his time watching Netflix or at his local soccer club (behind the bar, so he can drink with his mates). He is drinking 10 14 standard drinks per day (he favours an IPA).

Outline how PVD if left unchanged, may impact on the disability outlined in the case study (i.e. pathophysiology)