Peripheral Artery Disease
Peripheral artery disease (PAD) is a narrowing or blockage of the blood vessels carrying oxygen- and nutrient-rich blood to outlying or peripheral, areas of the body. In most cases, PAD affects the arteries in the legs or pelvic region. It is similar to other cardiac ailments in that it is caused by the buildup of fat, cholesterol and calcium on the interior walls of blood vessels.
Cramping, pain or tiredness in the leg or hip muscles during such mild exertion as climbing stairs or even just walking is the most common symptom of PAD. The disease often is mistaken for something else, especially because the pain generally goes away with rest. In extreme cases, the pain is constant, there are foot or toe wounds that do not heal and there is a noticeable decrease in the temperature of the lower leg or foot. If not diagnosed and treated, PAD can lead to very serious condition called gangrene and ultimately limb loss.
It is important not to dismiss leg pain as a sign of aging, stiffness or even arthritis. The pain from PAD occurs not in the joints, but in the muscles which are not getting proper blood flow. In addition, diabetics can confuse PAD with neuropathy, which also is a burning or painful discomfort in the feet, legs and thighs.
Your doctor has many diagnostic tools to uncover your PAD, but it starts with a discussion of your medical history and risk factors and a physical exam, including a check for weak pulse rates in your legs. One of the first tests for PAD is an ABI, or ankle-brachial index test, in which the blood pressure in your feet is compared to the blood pressure of your arm. Normally, the ankle pressure is 90 percent of the arm pressure but in severe PAD cases, the difference can be 50 percent or less.
If necessary, a number of other imaging tests can be performed to confirm the existence of PAD and gauge its severity. These include ultrasound procedures and several types of catheterization procedures. Both the computed tomographic (CT) and magnetic resonance (MR) versions are non-invasive while the so-called conventional catheterization involves the injection of contrast dye agents to identify areas of narrowing and blockage.
The most common, and effective, treatment for PAD is regular physical activity, as prescribed by your healthcare professional. Medications designed for treating high blood pressure and high cholesterol also can work on PAD as do anti-clogging drugs. In some instances, such minimally invasive procedures as balloon angioplasty or stent placement can be necessary and —in severe cases—a blood vessel from another part of the body can be transplanted to “bypass” the closed artery.
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