What is Peripheral Artery Disease?
Peripheral Artery Disease is a common pathological condition of the circulatory system in which the arteries become narrow or stenosed thus reducing blood flow to the various parts of the body, especially the extremities. When an individual develops Peripheral Artery Disease, the legs are the most affected and do not receive enough blood causing various symptoms specifically severe pain with ambulation. Peripheral Artery Disease is most commonly an indication of a more complicated condition called atherosclerosis which reduces blood flow to the heart and brain along with the legs. The major risk factor for Peripheral Artery Disease is tobacco and once you quit tobacco you more often than not treat this condition. Exercising and eating a balanced healthy diet also helps a great deal in treating Peripheral Artery Disease.
What Causes Peripheral Artery Disease?
The root cause of Peripheral Artery Disease is atherosclerosis. Atherosclerosis is a medical condition in which there is a gradual buildup of plaques in the arteries thus narrowing them and reducing flow of blood to various parts of the body. Atherosclerosis usually affects the arteries of the heart but it has a tendency to affect other arteries of the body as well. When this condition occurs in the arteries which transport blood to the extremities then it is called as Peripheral Artery Disease. In some cases inflammation of the blood vessels may also cause Peripheral Artery Disease along with some injury to the extremities or exposure to radiation.
What are the Risk Factors for Peripheral Artery Disease?
Some of the risk factors for Peripheral Artery Disease are:
Smoking as a Risk Factor for Developing PAD: This by far the most common cause of Peripheral Artery Disease and a smoker is always at an increased risk for developing this disease.
Diabetes Mellitus as a Risk Factor for Developing PAD: This condition also more often than not causes Peripheral Artery Disease.
Being Overweight as a Risk Factor for Developing PAD: An obese individual will be more at risk for developing Peripheral Artery Disease than an individual of normal weight
Hypertension: People suffering from Hypertension are also likely to get peripheral artery disease.
Age: This also plays a factor is developing of Peripheral Artery Disease and people above the age of 50 are at an increased risk
Family History: Individuals with a prior family history of cardiac disorders, stroke, or Peripheral Artery Disease are at increased risk for developing this condition.
What are the Symptoms of Peripheral Artery Disease?
Some of the symptoms for Peripheral Artery Disease are:
- Cramping associated with pain in the region of the hip, thigh and calf muscles usually after any sort of activity like walking or climbing
- Numbness and weakness of the legs are one of the symptoms of Peripheral artery disease.
- The lower part of the legs feeling cold to touch
- Delayed healing of bruises or sores in the legs or foot
- Discoloration of the legs can also be a symptom of Peripheral Artery Disease.
- Hair loss in the lower extremities
- Shiny skin on the legs
- In some cases, erectile dysfunction
- As the disease progresses the affected individual may feel pain even at rest and may be severe enough to interfere with activities and sleep.
How is Peripheral Artery Disease Diagnosed?
To confirm the diagnosis of Peripheral Artery Disease the following steps are taken:
Physical Examination to Diagnose Peripheral Artery Disease: The physician will start with a detailed physical examination looking for a weak pulse in the lower extremities. The physician will also look for any discoloration of the legs. The physician will ask you to walk around to see if you feel any pain with ambulation. The physician will do a percussion test looking for any audible bruits around the arteries suggesting stenosis or narrowing of the arteries. Also, if the patient states that wounds heal very slowly then that is also an indication of Peripheral Artery Disease.
Ankle-Brachial Index to Diagnose Peripheral Artery Disease: This one of the most preferred test for diagnosing Peripheral Artery Disease. This test distinguishes the blood pressure in the ankle and the arm and a comparison is made. The readings may be taken by making you walk on a treadmill as well so as to investigate the severity of the narrowing of the arteries.
Ultrasound: Imaging studies like a Doppler ultrasound can also help in identifying Peripheral Artery Disease.
Angiography: This is a test in which a dye in injected in the blood vessels and the physician checks the flow of the dye through the arteries. If there is any narrowing of the arteries it will be evident on the test. The tracking of the dye is done through imaging
Blood Tests: A blood test will be taken to check the status of the cholesterol and also look for any signs of diabetes.
How is Peripheral Artery Disease Treated?
Treatment of Peripheral Artery Disease is two-fold. One is to control the symptoms so that the patient is able to resume normal activities and the second is to stop the progression of the disease and cut down the risk of complications.
Lifestyle Changes for Peripheral Artery Disease: These can be done by simple lifestyle modifications like quitting tobacco, eating a well balanced and healthy diet, avoiding spicy food, keeping blood sugar under control if you are a diabetic.
In case if lifestyle changes are not effective in controlling the symptoms, then the physician may prescribe certain medications to control the symptoms. Some medications that are usually prescribed to treat Peripheral Artery Disease are:
Cholesterol Medications to Treat Peripheral Artery Disease: Medications which lower the cholesterol levels will be given like a statin which cuts down the risk factor for heart attacks and stroke.
Antihypertensives for Treating Peripheral Artery Disease: In case if the patient has hypertension, then control of blood sugar is of vital importance. Hence medications will be prescribed for controlling the blood pressure and bring it down to at least 140/90. For diabetics, this number goes down to 130/80.
Diabetes Medications: For diabetic patients, medications will be given for control of sugar.
Medications for Blood Clots: Since Peripheral Artery Disease increases the risk of blood clots it is important to cur down the risk and this can be done by taking medications like Plavix.
In case if medications are not able to control the symptoms appropriately, then surgical procedure in the form of angioplasty is carried out to treat Peripheral Artery Disease.
Angioplasty: This procedure involves inserting a catheter with a balloon into the affected artery and then the balloon is inflated expanding the artery and repair the blockage and stretching the artery as well to restore normal blood flow. The surgeon may then insert a stent so as to keep the artery expanded such that blood flow is not obstructed.
Bypass Surgery: This procedure involves bypassing the diseased area by creating a graft made of synthetic to bypass the blocked or narrowed artery and restore normal blood flow.
Supervised Exercise Program for Peripheral Artery Disease:
Once the patient is through with medication therapy and surgical procedure to repair the blocked artery then the physician will recommend a supervised exercise regimen so that the walking abilities which previously had been limited due to Peripheral Artery Disease increases and the patient is able to walk longer distances without having any pain.
What are the Dos and Don'ts for Peripheral Artery Disease?
The following are some of the dos and don'ts for an individual suffering from Peripheral Artery Disease:
Quit Tobacco: The very first thing is to quit tobacco, as smoking increases constriction of arteries and tends to worsen Peripheral Artery Disease.
Exercise: Indulging in diligent exercise program may go a long way in helping control the symptoms of Peripheral Artery Disease.
Diet: Eating a well balanced and healthy diet controls the blood pressure and cholesterol levels thus reducing any chances of complications from Peripheral Artery Disease.
Avoidance of Certain Classes of Medications: There are certain medications available in the market which can increase Peripheral Artery Disease. Such medications need to be avoided. Some of these medications are Advil Cold & Sinus, Aleve, Claritin, Sudafed, etc.
Why is Foot Care Vital for People with Peripheral Artery Disease and How is it Done?
This part is specifically dedicated to those individuals who have diabetes along with Peripheral Artery Disease, as they have extremely poor rate of healing of even small bruises or cuts which increases the risk for infection. Since Peripheral Artery Disease affects mostly the foot hence it is extremely vital to take care of the foot in order to avoid complications. Some of the ways to take care of the foot are:
- Washing the feet on a daily basis is recommended for people suffering from Peripheral Artery Disease, preferably use a moisturizer so that the bottom of the feet does not develop cracks which can be a source of infection.
- Wearing shoe wear that are well fitting and comfortable and do not cramp the foot.
- In case if you develop any type of infection in the foot then seek treatment immediately to prevent complications
- Keep the toenails trimmed at all times if you have PAD
- Try and not walk barefoot and wear slippers at all times
- Consult a foot doctor as soon as you see any sign of infection or a sore in the feet.