Peripheral Artery Disease (PAD)

Peripheral artery disease narrowed arteries and reduced blood flow to the limbs. This circulatory problem usually occurs in the extremities, especially legs. People with peripheral artery disease may have claudication or leg pain when walking due to the lack of blood supply.

Peripheral artery disease may be a sign of fatty deposit of the arteries which may also reduce blood flow to the heart and brain. The disease may be improved and treated by some changes of habits including quitting smoking, exercising and healthy dietary.

Symptoms  

The symptoms of peripheral artery disease might be mild or even noticeable at all. Claudication or leg pain when walking is the most common symptom of the disease. The symptoms of claudication also include muscle pain, cramping in the arms or legs which may disappear within a few minutes. Severity range of claudication can be from mild to severe which may affect your daily activity especially when walking.

Signs and symptoms of peripheral artery disease may include:

• • Claudication
  • Numbness or weakness of ares or legs
  • Coldness in lower legs
  • Sores on the toes
  • The change of color of the legs
  • Slower hair growth or hair loss on the feet and legs
  • Slower growth of toenails
  • Shiny leg skin
  • Weak pulse in legs or feet, no pulse on the areas found in some cases
  • Erectile dysfunction in men

The pain of peripheral artery disease can also occur during resting or lying down. The pain might get more intense during the night. You may hang your legs over the edge of the bed or walk around the room to relieve the pain.

When to see the doctor

you are advised to see the doctor if you have any symptoms above. People with peripheral artery disease who are at the age of 65 and over, over 50 with diabetes or smoking and under 50 with diabetes or other risks of the disease such as high blood pressure for diabetes are highly recommended to be screened.

Cause 

Peripheral artery disease occurs when there are plaques or fatty deposits developing in the artery wall. The reduced blood flow decreases blood flow to limbs. Peripheral artery disease might be the result of an injury to the limbs, unusual anatomy of ligaments or muscles or radiation exposure.

Risk factors           

            The risks  factors of peripheral artery disease may include:

• • Diabetes
  • Obesity
  • High blood pressure
  • High cholesterol
  • People at the age of 50 and above
  • People whose family member has involved with peripheral artery disease, heart disease or stroke
  • High levels of homocysteine or a protein component helping build and maintain tissue
  • Smoking

Complications

             Peripheral artery disease may increase the risk of:

• • Critical limb ischemia
  • Stroke
  • Heart attack

Diagnosis

To diagnose peripheral artery disease, the doctor may conduct several tests including:

• • Physical exam to evaluate the narrowed artery
  • Ankle-brachial index (ABI) to compare blood pressure between in ankle and arm
  • Ultrasound to evaluate blood flow through blood vessels
  • Angiography to check your blood flow
  • Blood tests to measure for possibility of diabetes, cholesterol and triglycerides

Treatment

The aims of the treatment are to manage the symptoms and to discontinue the progress of the atherosclerosis that may cause the risk of heart attack or stroke.

            The treatment for peripheral artery disease may include:

• Medications
  • Cholesterol-lowering medications
  • High blood pressure medications
  • Medications to control blood sugar
  • Medications to control blood clots
  • Symptoms relieve medication
• Angioplasty and surgery
  • Angioplasty to reopen the artery and increase blood flow
  • Bypass surgery - a graft bypass will be created by using a vessel from other parts of the body to promote a better blood flow.
  • Thrombolytic therapy a clot-dissolving drug will be injected into the blocked artery to increase blood flow
• Exercise program
  The purpose of the program is to improve the symptoms of peripheral artery disease and promote more efficiency of the use of oxygen.
• Changing of lifestyle and home treatment
  Peripheral artery disease can be also improved or treated by changing lifestyle and home treatment. You are advised to
  • Quit smoking
  • Exercise more often
  • Eat healthy dietary
  • Avoid some cold medications
  • Be careful of foot care such as, washing and dry feet daily, wearing dry socks and well-fitting shoes, treating any fungal infections, be careful when trimming nails, inspecting the injury of feet and seeing the doctor for any uncommon problems of feet to seek for appropriate treatment

Preparing for the appointment

Before your appointment, you may prepare yourself including:

• a list of your symptoms
• a list of your current medications
• questions that you want to ask the doctor

During the consulting, the doctor may ask some questions including the information such as:

• the beginning of your symptoms
• whether the symptoms is continuous or occasional
• whether the symptoms gets worse when exercising
• severity of the symptoms
• whether the symptoms gets better when resting
• whether you are smoking