What Is Peripheral Arterial Disease ?
Peripheral arterial disease (P.A.D.) occurs when plaque (plak) builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.
When plaque builds up in arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.
P.A.D. usually affects the legs, but also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs.
This refers to diseases of blood vessels outside the heart and brain. It's often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys.
There Are Two Types Of These Circulation Disorders:
- Functional peripheral vascular diseases don't have an organic cause. They don't involve defects in blood vessels' structure. They're usually short-term effects related to "spasm" that may come and go. Raynaud's disease is an example. It can be triggered by cold temperatures, emotional stress, working with vibrating machinery or smoking.
- Organic peripheral vascular diseases are caused by structural changes in the blood vessels, such as inflammation and tissue damage. Peripheral artery disease is an example. It's caused by fatty buildups in arteries that block normal blood flow
Exams and Tests
The classic symptom of leg pain on walking that stops with rest is a good indication of peripheral vascular disease. However, only about 40% of people with peripheral vascular disease have intermittent claudication.
Upon hearing your symptoms, your health care provider will formulate a list of possibilities.
- He or she will probably suspect intermittent claudication and several other conditions.
- How strongly he or she suspects peripheral vascular disease will depend largely on your risk factors.
- If you are young, healthy, active, and don't smoke, for example, peripheral vascular disease will not be a primary consideration.
- On the other hand, if you are older than 50 years, smoke, have diabetes, are overweight, are inactive, and have a family history of high cholesterol and atherosclerosis, peripheral vascular disease will be a primary consideration.
- The absence of a pulse in the legs or the arms will immediately result in a workup to rule out peripheral vascular disease.
Rose criteria : A test used by many medical professionals to screen for peripheral vascular disease is a series of 9 questions called the Rose criteria. The answers to these questions indicate whether you have peripheral vascular disease and how severe it is..
How Is Peripheral Artery Disease Diagnosed And Treated ?
Techniques used to diagnose PAD include a medical history, physical exam, ultrasound, X-ray angiography and magnetic resonance imaging angiography (MRA).
Most people with PAD can be treated with lifestyle changes, medications or both.
Lifestyle changes to lower your risk include:
- Stop smoking (smokers have a particularly strong risk of PAD).
- Control diabetes.
- Control blood pressure.
- Be physically active (including a supervised exercise program).
- Eat a low-saturated-fat, low-cholesterol diet.
PAD may require drug treatment, too. Drugs include:
- Medicines to help improve walking distance (cilostazol and pentoxifylline).
- Antiplatelet agents.
- Cholesterol-lowering agents (statins).
In a minority of patients, lifestyle modifications alone aren't sufficient. In these cases, angioplasty or surgery may be necessary.
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