Guidelines for Patients with Peripheral Vascular Disease
Peripheral vascular disease (PVD) broadly refers to
disease in any of the blood vessels outside of the heart or brain. It is
often a narrowing or blockage of the blood vessels in the legs, abdomen,
pelvis, arms or neck. PVD most commonly affects arteries in the leg,
abdomen and pelvis. When these arteries become narrowed or blocked
because of atherosclerosis, or a buildup of plaque in the
artery walls, blood flow is restricted. This arterial form of PVD is
called peripheral arterial
The more risk factors a person has, the more likely he or she will
develop PVD. The risk factors for PVD include:
Hypertension (high blood pressure)
PVD cannot be cured or prevented, but you can control certain risk
factors by changing your 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
your diet, you may reduce the risk of atherosclerosis.
Hypertension: Untreated hypertension adds to the
work load of the heart and creates stress on the arteries. Have your
blood pressure checked regularly and take medications as ordered by your
doctor. Your doctor may suggest stress management classes or a low-salt
Diabetes: People with diabetes are especially prone to
atherosclerosis. It is important to follow the recommendations
of your healthcare team regarding diet, treatment and medications.
Exercise: Get regular exercise. Before engaging in any
exercise program, consult your physician.
Symptoms of PVD
Pain during exercise (called intermittent claudication)
Cold and/or numb feet or toes
Sores that are slow to heal
Leg pain at rest
Symptoms vary by individual, and some people with PVD do not have any
Physical Signs of PVD
Pale skin of the legs that gets worse with exercise or when the
legs are elevated
Loss of hair on the feet and toes
Redness in the feet and toes when dangling
Blue or purple marks on the legs, feet or toes
Ulcers on the feet or toes
Black skin on the legs or feet that indicates necrosis (the
death of tissue)
Exams and Tests
Your doctor may recommend testing for PVD when you have related
symptoms. A medical history and physical exam
are usually part of an evaluation for PVD. If your doctor suspects you
may be at risk for PVD, he or she will likely examine you for any
physical signs of the disease. If the history and physical exam suggest
that you may have PVD, an ankle-brachial index test (ABI)
is often the first step to confirming the diagnosis and helps determine
its severity. The test compares the blood pressure at your ankle and arm
both at rest and after light exercise. The blood pressure readings can
help clarify whether blood flow is reduced, which may indicate PVD. You
may also have tests that provide more detail on the condition of the
arteries. They may include one or more of the following:
Magnetic resonance angiography (MRA)
If you are diagnosed with PVD, you should also be screened for other
atherosclerosis-related diseases. Blood vessels that supply the heart
and brain are especially important to monitor for narrowing or blockage
because of the risk of coronary artery disease, heart attack or stroke.
A Final Word
Advances in vascular surgery allow for treatment of atherosclerosis with
low risk of complications. Surgery may improve or eliminate symptoms,
but it is not a cure. Keeping follow-up appointments and reducing risk
factors will help you control further disease.
Bryn Mawr Hospital
The Wound Healing Center at Bryn Mawr Hospital
130 South Bryn Mawr Avenue
Ground Floor, E-Wing
Bryn Mawr, PA 19010
For more information, call 1.866.CALL.MLH.