Treating and Diagnosing PAD
Peripheral arterial disease (PAD), is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels — the arteries, veins or lymphatic vessels. Organs such as the brain, heart and legs may not receive adequate blood flow for ordinary function. The legs and feet are most commonly affected.
PAD often involves the narrowing of vessels that carry blood to the legs and arms. The most common cause is atherosclerosis (the buildup of plaque inside the artery wall). Plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue. Clots may form on the artery walls, potentially blocking off major arteries. People with PAD are at increased risk for heart disease, aortic aneurysm and stroke. PAD is also a marker for conditions including diabetes and hypertension.
Symptoms of Possible Peripheral Arterial Disease
Symptoms of possible PAD include a combination of the following symptoms:
- Claudication (leg pain that occurs when walking/exercising and disappears when you stop)
- Numbness and tingling in your lower legs and feet
- Cold lower legs and feet
- Slow-healing ulcers or sores legs and feet
- Change in leg color
- Hair loss on feet and legs
- Changes in nails
- Ischemic rest pain (where pain occurs whether at rest or lying down)
Diagnosing and Treating PAD
To determine whether you have PAD, diagnostic procedures may be performed, including:
- Angiogram: A thin tube is placed in an artery in the leg and injected with a contrast dye, making the veins visible on an x-ray
- Ankle-brachial index (ABI): Comparing the blood pressure in the ankle with the blood pressure in the arm
- Blood lipid profile: A blood test to measure the levels of different fats in the blood
- Doppler ultrasound flow studies: High-frequency sound waves are used to create images of blood vessels, tissues and organs and to assess the blood flow
- Magnetic resonance angiography: A magnet, radio frequencies and a computer are used to produce detailed images of organs
- Treadmill exercise test: The heart is monitored while a patient walks on a treadmill
- Photoplethysmography: Similar to an ABI, except it uses a tiny blood pressure cuff on the toe and a sensor to record blood pressure measurements. The measurements are compared to the arms systolic blood pressure
- Segmental blood pressure measurements: Comparing blood pressure in the upper thigh, above and below the knee, at the ankle and on the arm
Treatments may include aggressive treatment of existing conditions that may aggravate PAD, such as diabetes and hypertension, medications for improving blood flow, such as blood thinners, and medications that relax the blood vessel walls. Physicians may also choose to perform a type of angioplasty to widen the arteries or vascular surgery.
Often PAD can be treated with healthy lifestyle changes. Sticking to an exercise plan, cutting out smoking, and eating a better diet are sometimes all that is needed to prevent the further progression of the disease. Taking extra care of feet by wearing thick, dry socks prevents moisture from accumulating and lessens the chance of a fungal infection. Being careful when trimming toenails is also important, as well as promptly treating any sores or fungal infections as soon as they appear.