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 disease (PAD).
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 diet.
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 symptoms.
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.