Peripheral Artery Disease (PAD)

Peripheral Artery Disease Symptoms, Causes & Diagnosis

Peripheral artery disease is a common circulatory condition, in which narrowed arteries limit blood flow through your limbs (also known as peripheral artery disease)

If you develop peripheral artery disease (PAD), your extremities—usually your legs—do not obtain enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (claudication).

Peripheral artery disease is also likely to be a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis). This can reduce the flow of blood to your heart and brain, as well as to your legs.

By quitting smoking, exercising and eating a healthy diet, you can often successfully treat peripheral artery disease.

Symptoms

Experts claim that about half of all people with PAD do not know they have a condition; this is because many people have no symptoms. Possible signs shall include:

Loss of hair on the legs and legs.
Intermittent claudication – the muscles of the thigh or calf may feel pain when walking or climbing the stairs; some people complain of painful hips.
The leg's weakness.
Your foot or lower leg can feel cold.
The numbness of the legs.
The toenails of Fragile.
Toenails are rising slowly.
Sores or ulcers on the legs and legs that take a long time to heal (or never heal).
The skin on the legs becomes shiny or pale or bluish.
Difficulty in detecting a pulse in your leg or foot.
Erectile dysfunction (male impotence, difficulties with achieving or maintaining erection).

Cause of Peripheral Artery Disease

Atherosclerosis is the most common cause of PAD. Atherosclerosis is a progressive mechanism in which a fatty substance is formed within the arteries.

Less common causes of peripheral artery disease include blood clots in the lungs, limb damage, and irregular anatomy of muscles and ligaments.

Risk factors that contribute to PAD include diabetes, smoking, obesity, high blood pressure, growing age, high cholesterol, family history of heart disease, and excess levels of C-reactive protein or homocysteine.

What are the conditions for PAD?
If left untreated, patients with Peripheral artery disease PAD can develop serious health problems, including:

Heart attack: irreversible damage to the heart muscle caused by a long-term loss of blood flow to the heart.
Stroke: cessation of supply of blood to the brain
Transient ischemic attack (TIA): transient disruption of blood supply to the brain)
Renal artery disease or stenosis: narrowing or obstruction of the artery that supplies blood to the kidney
Amputation: removal of part or all of the foot or leg (rarely the arm), particularly in people who have diabetes.

How's peripheral artery disease diagnosed?

There are many ways in which PAD can be identified, if the disease is suspected, the doctor will first examine the patient’s legs.

Ankle-brachial index – the most common PAD measure, a test that compares blood pressure in the ankle with blood pressure in the arm.
Ultrasound screening, angiography, and blood tests – cholesterol, homocysteine, and C-reactive protein levels can also be recommended.
Doppler and ultrasound (Duplex) imaging – a non-invasive approach that visualises the artery with sound waves and monitors the flow of blood in the artery to show the presence of a blockage
Computed tomographic angiography (CT) – another non-invasive examination that reveals the arteries of the patient's abdomen, pelvis, and legs. This test is especially useful for patients with pacemakers or stents.
Magnetic Resonance Angiography (MRA) – offers similar information to that provided by a CT scan, but without the need for X-rays.
Angiography – this is usually reserved for use in conjunction with vascular treatment procedures. A contrast agent is inserted into the artery during an angiogram
X-rays are taken to demonstrate blood flow and to locate any blockages that may be present.
Undiagnosed or untreated Peripheral artery disease can be dangerous; it can lead to debilitating symptoms, loss of the leg, increased risk of coronary artery disease, and carotid atherosclerosis (the narrowing of the arteries that supply blood to the brain)
Since people with PAD have an elevated risk of heart attack and stroke, the American Heart Association urges people at risk to discuss PAD with their physician to ensure early diagnosis and care.

Peripheral Artery Disease Treatment options

A 2011 ACCF/AHA A based update of a guideline for the treatment of patients with a peripheral artery disease (Upgrading the 2005 Guideline) was prepared in collaboration with the American College of Cardiology Foundation and the American Heart Foundation. The text was released in the newspaper Circulation.

They recommend:

Regular physical activity – this is the most successful therapy, and a supervised fitness training programme is also prescribed by the doctor. The patient may have to start slowly. Easy walking regimens, leg exercises, and treadmill workout programmes three days a week will lead to reduced symptoms in just 4-8 weeks.

Diet changes and modifications – many people with PAD have elevated cholesterol levels. A diet low in saturated fat, trans fat and cholesterol, as well as many fruits and vegetables, can help lower blood cholesterol levels.

The risk of PAD, heart attack and stroke is significantly increased by smoking cessation-tobacco smoke. Smokers may have four times the risk of developing PAD than nonsmokers. Stop smoking will lead to slowing the growth of PAD and other cardiac illnesses.

Some medications – the doctor may prescribe antihypertensive drugs as well as statins to lower cholesterol levels. Cilostazol and pentoxifylline may be prescribed in patients with intermittent claudication. ACE inhibitor ramipril has been shown to enhance pain-free walking by 60% in a study published in JAMA.

Exercise for intermittent claudication must take into account the fact that walking can be painful. The program consists of alternating between activity and rest.

If the above-mentioned treatments are not helpful enough the doctor can advise angioplasty – surgery to unblock or fix a blood vessel.

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