Overview
Peripheral artery disease (PAD) is a common condition characterized by narrowed arteries, which reduce blood flow to the arms or legs. PAD typically occurs due to a build-up of fatty deposits in the arteries (atherosclerosis). As a result, the affected limbs (usually the legs) receive insufficient blood flow, causing symptoms such as leg pain when walking (claudication) and other related issues. PAD can be prevented and managed through a healthy lifestyle, including not smoking, exercising, eating a balanced diet, controlling blood sugar, blood pressure, and cholesterol.
Understanding the disease
Symptoms
The symptoms of peripheral artery disease (PAD) may include:
- Leg pain or cramping in the calf muscle that occurs during exercise and subsides with rest. The pain can range from mild to severe.
- Coldness in the lower leg or foot, especially when compared to the other side.
- Leg numbness or weakness.
- No pulse or a weak pulse in the legs or feet.
- Painful cramping in the hips, thighs, or calf muscles after certain activities, such as walking or climbing stairs.
- Shiny skin on the legs.
- Changes in skin color on the legs.
- Slower growth of the toenails.
- Sores on the toes, feet, or legs that won't heal.
- Pain when using the arms, such as aching and cramping when knitting, writing, or doing other manual tasks. If peripheral artery disease worsens, pain may occur during rest or when lying down, interrupting sleep. Hanging the legs over the edge of the bed or walking may provide temporary relief. It is essential to consult a healthcare provider if you experience any of these symptoms.
Risk Factors
Risk factors for developing peripheral artery disease include smoking or having diabetes, a family history of peripheral artery disease, heart disease, or stroke, high blood pressure, high cholesterol, high levels of homocysteine, increasing age (especially after 65 or after 50 with risk factors for atherosclerosis), and obesity (a body mass index over 30).
Development
Peripheral artery disease (PAD) develops when the arteries in the limbs, usually the legs, become narrowed due to a buildup of fatty deposits called plaques. This process is called atherosclerosis. The narrowed arteries reduce blood flow to the limbs, causing symptoms such as leg pain when walking (claudication) and other issues. Atherosclerosis is the most common cause of PAD. Less common causes include blood vessel inflammation, injury to the arms or legs, changes in muscles or ligaments, and radiation exposure. Risk factors include smoking, diabetes, high blood pressure, high cholesterol, high levels of homocysteine, increasing age, and obesity. If left untreated, complications can include slow growth of toenails, non-healing sores, pain in the arms, erectile dysfunction, and hair loss or slower hair growth on the legs. Critical limb ischemia, stroke, and heart attack can occur in severe cases.
Assessment and Diagnosis
Triage
You should see a doctor if you have leg pain, numbness, or other symptoms of peripheral artery disease (PAD). These symptoms could indicate a buildup of fatty deposits in the arteries, which reduces blood flow to the limbs. Early diagnosis and treatment can help manage the condition and prevent complications, such as critical limb ischemia, stroke, or heart attack.
Diagnosis
To diagnose peripheral artery disease, a health care provider will examine you, ask questions about your symptoms and medical history, and may perform tests such as blood tests, ankle-brachial index (ABI), ultrasound of the legs or feet, or angiography. The ABI test compares blood pressure in the ankle with the blood pressure in the arm, and can be done with or without exercise. Other tests can visualize blood flow and check for blockages in the arteries.
Management and Treatment
Complications
Potential complications of peripheral artery disease include critical limb ischemia, stroke, and heart attack. Critical limb ischemia can cause tissue death and may require amputation. Atherosclerosis, the underlying cause of peripheral artery disease, can also lead to complications in the blood vessels of the heart and brain, resulting in heart attack and stroke. It is important to maintain a healthy lifestyle to prevent leg pain due to peripheral artery disease, which includes not smoking, controlling blood sugar, eating a low-fat diet, exercising regularly, maintaining a healthy weight, and managing blood pressure and cholesterol.
Prevention
Peripheral artery disease can be prevented by maintaining a healthy lifestyle. This includes not smoking, controlling blood sugar, eating a diet low in saturated fat, engaging in regular exercise, maintaining a healthy weight, and managing blood pressure and cholesterol levels. By following these measures, you can reduce your risk factors and potentially prevent the development of peripheral artery disease.
Home Remedies
There are no specific home remedies suggested for peripheral artery disease. However, peripheral artery disease treatment includes exercising, eating a healthy diet, and not smoking or using tobacco. If you have leg pain, numbness or other symptoms of peripheral artery disease, you should call your healthcare provider. It is important to note that peripheral artery disease is a serious condition and it is recommended to consult with a healthcare professional for proper diagnosis and treatment.
Treatment
Treatments for peripheral artery disease (PAD) include lifestyle changes, medications, and surgical procedures.
- Lifestyle changes: Maintaining a healthy lifestyle is essential in managing PAD. This includes not smoking or using tobacco, controlling blood sugar, eating a healthy diet low in saturated fats, engaging in regular exercise, maintaining a healthy weight, and managing blood pressure and cholesterol levels.
- Medications: Depending on the severity of the condition, various medications might be prescribed. These can include antiplatelet drugs (such as aspirin) to prevent blood clots, cholesterol-lowering drugs, and blood pressure medications.
- Surgical procedures: In some cases, surgical interventions may be necessary to improve blood flow. These can include angioplasty (a balloon is inserted to widen narrowed arteries), stent placement (a small mesh-like tube is inserted to keep the artery open), and bypass surgery (a healthy blood vessel is taken from another part of the body and used to create a new path for blood flow around the blocked artery). It is essential to consult with a healthcare professional to determine the most appropriate treatment plan for each individual case.
Preparing for medical consultation
To prepare for an appointment for peripheral artery disease (PAD), you should:
- Make a list of your symptoms, including any that may seem unrelated to PAD.
- List all medications, vitamins, or supplements you're taking, including dosages.
- Write down questions to ask your healthcare provider, such as the causes, types of tests, available treatments, potential side effects, alternatives to primary treatment, and how to manage other health conditions.
- Gather medical records, including previous imaging reports, and send them to your healthcare provider in advance if possible.
- Bring a family member or friend with you for support and to help remember important details.
- Be prepared to discuss your diet, exercise habits, and tobacco use, as well as any challenges you may face in making lifestyle changes.
- If you smoke, try to quit or ask your healthcare provider for strategies to help you quit.
- Consider incorporating healthy lifestyle habits like eating less saturated fat and adding more fruits and vegetables to your diet. Remember to ask additional questions during your appointment if you don't understand something or need further clarification.