Peripheral Arterial Disease Defined

Peripheral vascular disease (PVD) is a general term for disease of any blood vessel that is not part of the heart or brain. The arterial form, usually referred to as PAD, is caused by deposits of fatty material (atheroma) in arteries of the legs or internal organs. Since arteries carry oxygen-rich blood to the cells of the body, restriction of this blood flow can cause bodily organs to fail.

This is a potentially serious condition that requires care from your doctor. The sooner PAD is treated, the more favorable the outcome. If you suspect you have this condition, contact your doctor.

PAD is usually caused by a gradual buildup of plaque in the arteries (atherosclerosis). Other causes include blood clot or embolism, congenital heart disease, inflammation of the blood vessels (vasculitis), and aortic dissection.

Who is at Risk?
The more risk factors a person has, the more likely he or she will develop PAD. The risk factors for PAD include:

• Smoking
• High cholesterol
• Heart disease
• Diabetes
• Obesity
• High blood pressure
• Family history

Symptoms of PAD:

• Pain when walking
• Pain at rest
• Decrease in leg hair growth
• Paleness of leg or foot when raised
• Numbness or tingling
• Cool temperature of the skin
• Sore or wound that will not heal

Foot Care
When blood flow to the legs is decreased, small injuries to the feet or toes may result in serious infections, sores or tissue death (gangrene). You need to:

• Avoid situations that might cause foot injury.
• Never expose your feet to extreme heat or cold or strong chemicals.
• Wash and dry your feet thoroughly, but do not soak them.
• Avoid going barefoot.
• Wear new shoes only for short periods of time.
• Inspect your shoes. Check for objects that could injure your feet.
• Inspect your feet daily. This is especially important if you have diabetes and/or decreased sensation in your feet.
• Use a mirror if you have trouble seeing the bottoms of your feet.
• Check for areas of warmth, swelling, sores or drainage.
• Perform proper foot hygiene.
• Cut toe nails straight across and not shorter than the length of the toe.
• Corns, calluses and bunions should be treated by a podiatrist.
• Special Shoes or inserts may reduce callus formation and promote control.
  

A Final Word
With recent advances in vascular surgery, atherosclerosis may be treated with a low risk of complications. Surgery may improve or remove symptoms, and restore you to a more independent lifestyle. Surgery does not cure atherosclerosis. The disease process is still present. You can help to control this. A firm commitment to keep follow up appointments with your doctor and reduce risk factors will help to control further disease.

Prevention
We cannot totally cure or prevent arterial disease (atherosclerosis), but we can control certain risk factors by changing our health habits.

• Smoking: Tobacco in any form should be avoided. Nicotine causes the blood vessels to constrict, which prevents the normal amount of blood from reaching the organs and extremities, and increases the risk of atherosclerosis. Smoking also decreases the amount of oxygen in the blood, and may be associated with blood clot formation.

• Diet: By reducing cholesterol and saturated fats in the diet, you may reduce the risk of atherosclerosis.

• High Blood Pressure: Untreated high blood pressure (hypertension) adds to the workload of the heart and creates stress on the arteries. Have you blood pressure checked regularly and take medications as prescribed by your doctor. Your doctor may suggest stress management classes or a salt restricted diet.

• Diabetes: People with diabetes are especially prone to atherosclerosis. It is important to follow the recommendations of a health care team regarding diet, treatment and medications.

• Exercise: Mild, regular, or daily exercise aids in the control of atherosclerosis.

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