You’re out enjoying the day when leg pain, cramps, or weakness stops you in your tracks. If this sounds familiar, you may have peripheral artery disease. Instead of dismissing persistent weakness or leg pain, you should seek a diagnosis and treatment from a cardiac specialist. Dr. Saquib Samee at the Commonwealth Vein Center in Colonial Heights, VA has more than 20 years of experience treating heart conditions, including PAD.
What Is Peripheral Artery Disease?
PAD is when the peripheral arteries of the body become narrowed, causing blood flow to become restricted. It can occur in any of the arteries that are away from the heart, such as the ones that serve the arms, legs, head, and stomach.
It is very common, affecting between 10% to 20% of Americans over the age of 60. It is a leading cause of heart attacks and strokes in that age group. Peripheral artery disease occurs in African Americans more than other racial groups. Additionally, men are at a slightly higher risk to develop it than women.
There can be serious consequences if PAD is left untreated. However, lifestyle modifications like eating a healthy diet low in processed sugars and carbohydrates and increased physical activity can substantially improve symptoms.
What Causes It?
PAD is most commonly caused by atherosclerosis, a condition marked by fatty deposits that build up along the walls of arteries. Restriction can limit the blood supply to affected areas. Plaque buildup can also rupture, leading to complete blockage of the arteries.
Anything that restricts blood flow within the arteries can be a cause of peripheral artery disease. Some causes in addition to atherosclerosis include
- Congenital defects of arteries or supportive tissue
- Injury or trauma to the affected area
- Blood clots in the arteries that are not related to plaque buildup
How Is PAD Diagnosed?
Receiving a diagnosis for PAD is relatively straightforward. The condition of your legs will often give a strong indication that PAD is involved. Checking the blood pressure in your ankle and comparing it to that in your arm can indicate a narrowing of your arteries. We can also run diagnostic tests to establish your levels of cholesterol, homocysteine, and C-reactive protein.
Imaging tests that allow us to see the blood flow inside your arteries and their structure are also incredibly helpful in establishing a diagnosis. X-rays, computed tomographic angiography, Magnetic Resonance Angiography, and ultrasound can all be useful tools in establishing a PAD diagnosis.
Using a dye as a contrasting material that will be injected directly into your blood vessels, an Angiogram is a test that enables your doctor to view blood flow through your arteries while it happens. Your doctor will be able to observe the contrast material flow through your arteries using techniques like X-ray imaging or with the use magnetic resonance angiography (MRA) or computerized tomography angiography (CTA).
Catheter angiography is another form of testing. It is much more of an invasive procedure in which the dye is injected into a catheter that is guided through an artery located in your groin into the affected area. Although it is invasive, Catheter angiography allows diagnosis and treatment at the same time.
What Are the Symptoms of PAD?
The most common symptoms of peripheral artery disease involve cramping and pain in the legs or hips. This results from a lack of blood supply and oxygen due to narrowed arteries. However, it is not the only sign of PAD. Some others that can indicate that blood is restricted in your arteries include:
- Pain in the hips or intermittent pain in the calves when walking
- Weakness in the legs
- Unexplained hair loss on the feet and legs.
- Brittle toenails
- Coldness in the foot or lower leg
- Numbness in the legs and feet
- Sores or ulcers on the legs and feet that take a long time to heal or never heal
- Toenails that grow slowly
- Shiny, bluish or pale skin in the extremities, particularly the legs
If you have noticed any of these signs, especially if you have more than one, you should see a specialist. Dr. Saquib Samee can help you find out what is causing your symptoms.
How Is It Treated?
Treatments for PAD will depend on the severity of your condition. Many people can successfully reduce plaque buildup by making changes to their lifestyle.
- Eat a healthy diet low in sugar, processed foods, refined carbohydrates, and transfats
- Increase physical activity to meet AHA recommendations of 150 minutes per week
- Quit smoking
Medications are also immensely helpful at reducing symptoms and buildup. The most common types of drugs used are antihypertensives. These reduce blood pressure and, as a direct result, the strain within the arteries. Ramipril is an ACE inhibitor that acts to reduce hypertension. It has been shown to reduce the risk of heart attack and stroke in those with PAD. They may also help individuals with peripheral artery disease feel more comfortable when walking.
Stains are also widely used. They lower the amount of lipids that are circulating in your blood to help limit buildup. For those with severe narrowing, medications and lifestyle changes may not be enough. In those cases, an angioplasty can be performed. This involves a small, balloon-like device being inserted into the artery through a catheter. It is then inflated to increase the inside diameter of the affected area. A mesh stent may be placed to hold it open.
Who Is at Risk?
One of the greatest risk factors for peripheral artery disease is age. Once you reach 50, your risk will continue to increase. Other factors also increase the risk of developing PAD. Your risk will be greater if you:
- Are 65 or older
- Are a current or former smoker
- Suffer from high cholesterol or blood pressure
- Have been diagnosed with diabetes
- Have been diagnosed with another vascular disease
- Have a family history of PAD
Stop PAD In Its Tracks
Peripheral artery disease is a common condition that can lead to serious cardiac complications. It often presents as weakness, pain, or cramping in the legs. Lifestyle modifications, medications, and surgical options are available to treat PAD. Early diagnosis and treatment is key to improving your prognosis.