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Peripheral Artery Disease - Legs

Peripheral Artery Disease - Legs

PVD, PAD, or peripheral vascular disease Acute obliterative artery disease; artery blockage in the legs; adjudication sporadic claudication leg vascular occlusive disease; the legs’ arterial insufficiency; persistent cramps and agony in the legs; Exercise-related calf pain

Blood vessel disease of the legs and feet is known as peripheral artery disease (PAD). It happens as a result of the legs’ arteries constricting. Reduced blood flow from this can harm other tissues, including nerves.

Causes

The common cause of PAD is atherosclerosis. This issue arises when plaque, or fatty material, accumulates on the artery walls, narrowing the arteries. Additionally, the artery walls stiffen and lose their ability to dilate, or broaden, to permit increased blood flow when necessary.

As a result, when your leg muscles are working harder (as during exercise or walking), they are unable to receive adequate blood and oxygen. Even when the muscles are at rest, there might not be enough blood or oxygen if PAD gets severe.

PAD is a prevalent condition. Men over 50 are typically affected, while women might also have it. A person’s risk increases if they have previously experienced:

  • Abnormal cholesterol level in the blood
  • Diabetes
  • Coronary artery disease, or heart disease
  • Hypertension, or elevated blood pressure
  • Illness of the kidney requiring hemodialysis
  • Smoking
  • Cerebrovascular illness, or stroke

Symptoms

Pain, achiness, exhaustion, burning, or discomfort in the thighs, calves, or foot are the primary signs and symptoms of PAD. The majority of the time, these symptoms start while exercise or walking and go away after a few minutes of relaxation.

  • Initially, these symptoms could only show up when you walk longer distances, quicker, or uphill.
  • These symptoms start off more quickly and require less exercise as time goes on.
  • When you’re at rest, your feet or legs could feel numb. The skin on the legs may appear pale, and they may feel chilly to the touch.

 

When severe PAD sets in, you could experience:

  • Impotence
  • Cramps and pain at night
  • Even the weight of clothing or bed linens can cause excruciating pain or tingling in the feet or toes.
  • Leg pain that gets better when you dangle your legs over the side of the bed and gets worse when you lift your legs
  • Dark, blue-looking skin
  • Unhealing sores

Exams and Tests

During a checkup, the medical professional could discover:

  • When the stethoscope is placed over an artery, a whooshing sound is heard (arterial bruits)
  • Blood pressure in the afflicted arm dropping
  • weak or nonexistent limb pulses

 

Findings in cases of more severe PAD could include:

  • Muscles in the calf that atrophy or wither
  • Loss of hair on the toes, foot, and legs
  • painful, slow-healing, non-bleeding ulcers on the foot or toes, usually black
  • Skin pallor or a blue tint to the toes or foot (cyanosis)
  • Shiny, constricted skin
  • Huge toenails

 

Diabetes or excessive cholesterol may be detected by blood tests.

Among the PAD tests are:

  • Angiogram of the lower limbs
  • Ankle/brachial index, or ABI, is the blood pressure measured in the arms and legs for comparison.
  • Doppler ultrasonography examination of a limb
  • Also known as CT angiography or magnetic resonance imaging

Treatment

Among the things you can do to manage PAD are:

  • Strike a balance between training and recovery. Walk or engage in another activity until it hurts, then take breaks. Your circulation may get better over time as new, tiny blood vessels develop. Consult the provider first before beginning an exercise regimen.
  • Give up smoking. Smoking causes blood vessels to narrow, reduces oxygen-carrying capacity of the blood, and raises the risk of blood clots (thrombi and emboli).
  • Especially if you also have diabetes, take good care of your feet. Put on appropriately fitting shoes. Observe any wounds, scrapes, or injuries, and contact your healthcare professional straight away. Reduced circulation slows the healing process of tissues and increases their susceptibility to infection.
  • Ensure that your blood pressure is under control.
  • Lose weight if you are overweight.
  • Eat a low-fat, low-cholesterol diet if your cholesterol is high.
  • If you have diabetes, watch your blood sugar levels and maintain appropriate levels.

 

Medications such as the following may be required to manage the disorder:

  • Aspirin or clopidogrel (Plavix), a medication that prevents blood clots from developing in your arteries. NEVER QUIT taking these medications without first consulting your doctor.
  • For moderate-to-severe situations that do not lend themselves to surgery, clotazol is a medication that acts to dilate (enlarge) the afflicted artery or arteries.
  • Medication to assist in cholesterol reduction.
  • painkillers.

 

Take your medications as directed by your doctor if you have diabetes or high blood pressure.

Surgery can be necessary if the illness is severe and impairs your capacity to work or perform other essential tasks, if you experience pain while at rest, or if you have ulcers or sores on your leg that won’t go away. Choices include:

  • Procedure to unblock or widen blood arteries supplying your legs with blood
  • Surgery to bypass a blocked artery and reroute the blood supply

 

It can be necessary for some PAD patients to have their limb amputated.

Outlook (Prognosis)

The majority of leg PAD cases are manageable without surgery. Surgery is still a useful option for severe cases of pain relief, although angioplasty and stenting techniques are increasingly being employed in its stead.

Possible Complications

Possible complications include:

  • Emboli or blood clots that obstruct tiny arteries
  • Heart disease caused by arteries
  • Impotence
  • Open sores (lower leg ischemia ulcers)
  • Death of tissue (gangrene)
  • Amputating the afflicted limb or foot can be necessary.

When to Contact a Medical Professional

Speak with your supplier if you have:

  • A foot or leg that turns numb, pale, blue, or chilly to the touch
  • Leg pain coupled with shortness of breath or chest pain
  • Leg pain that persists even when you are not moving or walking; this type of pain is referred to as rest pain
  • Red, heated, or swollen legs
  • Fresh wounds or sores
  • Infection symptoms (fever, redness, overall malaise)
  • Indications of extremity arteriosclerosis

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Prevention

It is not advised to use a screening test to diagnose PAD in individuals who do not exhibit symptoms.

You CAN alter a few of the risks associated with artery disease, including:

  • Refraining from smoking. If you smoke, give it up.
  • Lowering your cholesterol with medication, food, and exercise.
  • Lowering blood pressure using medication, exercise, and diet, if necessary.
  • Managing diabetes with nutrition, exercise, and medication as necessary.
  • 30 minutes or more of exercise each day.
  • Maintaining a healthy weight by cutting back on food, eating well, and, if necessary, enrolling in a weight-loss program.
  • Acquiring stress-reduction techniques via specialized courses, programs, or activities like yoga or meditation.
  • Limiting your alcohol consumption to one drink for ladies and two for men every day.