PERIPHERAL ARTERIAL DISEASE

WHAT IS PERIPHERAL ARTERIAL DISEASE – PAD?

The arteries are the blood vessels that carry the blood from the heart to all the areas of the body. Peripheral arterial disease (PAD) is a condition in which fatty deposits (called plaque) build up along the walls of the arteries that carry blood to the arms and legs. This is also known as arteriosclerosis or hardening of the arteries. The arteries slowly narrow and may even become blocked, affecting blood circulation, especially in the legs and feet.

WHAT ARE THE SIGNS OF PAD?

• Cramping pains in the legs or hip muscles with walking, that stops during rest or feelings of numbness, weakness or heaviness of the legs with no pain can be a signs of PAD.
• Burning or aching in the feet and toes while at rest, particularly while lying flat.
• Cooling of the skin in specific areas of the legs or feet.
• Color changes in the skin, particularly in the arms or legs.
• Sores (wounds or ulcers) on the feet and toes, especially ones that do not heal.
• No pulses in the feet (20-50% of patients with PAD have no symptoms – Peripheral Arterial Disease Coalition).

WHAT ARE THE RISKS – WHAT CAN HAPPEN?

The six signs listed above may mean that an artery is being blocked. This is a progressive condition. Left alone, it will get worse. If sores do not heal, they will allow bacteria to enter and start a deep infection of the soft tissue or bone. If there is inadequate blood flow, a procedure to increase the circulation by making the artery wider (angioplasty) or surgery to replace a portion of the artery may be necessary. If there is a part of the foot that will not heal, this may require amputation. “In the next five years, one in four patients with peripheral arterial disease will suffer a heart attack, stroke, amputation or death” – Peripheral Arterial Disease Coalition.

WHO IS AT RISK?

• Smoking is the number one risk factor for PAD and will interfere with treatment of the disease. People with PAD should stop smoking completely because even 1 or 2 cigarettes daily can affect treatment.
• Diabetes is a significant risk factor for PAD. People with diabetes should keep strict control of the their blood sugar to avoid serious problems resulting from PAD.
• Older age is a predictor for PAD. It occurs more frequently in those 60 years of age or older.
• People with a family history of heart disease are at greater risk for PAD.

HOW DO YOU TEST FOR PAD?

The first step is to perform a non-invasive vascular examination. This is a simple test done by placing blood pressure cuffs about the leg at different levels to measure the blood pressure and obtain a image of the pulse wave form. This will give your doctor an excellent idea of if there is evidence of PAD. Your doctor can then advise you if you need and treatment at all or if further testing is necessary.

WHEN SHOULD YOU BE TESTED FOR PAD?

If you have any of the six Signs of PAD you should have a non-invasive vascular exam.