Walk away from the pain
According to the American Heart Association (AHA), at least 8 million people in America suffer from peripheral arterial disease (PAD) with a higher prevalence in both the elderly and black communities. It is important to be informed of the causes, symptoms and treatments of PAD and the complications associated with it.
Peripheral arterial disease affects the arteries outside the heart, especially those in the pelvis and legs, and is caused by atherosclerosis, or hardening and narrowing of the arteries. This happens when plaque, caused by fats and cholesterol, builds up on the walls of the arteries, restricting the flow of blood. If the plaque becomes brittle and ruptures it can cause a blood clot and this clot can either further narrow the artery or block it completely. Clots in the coronary artery in the heart cause heart attacks and in the carotid artery in the neck they cause strokes.
When blockage, whether caused by plaque or a clot, occurs in the peripheral arteries it can cause a variety of symptoms. Some are as minor as pain in the legs or changes in skin color, but, depending on the length of time and degree of the blockage, peripheral arterial disease can lead to complete loss of circulation to the legs. This can cause gangrene, and, eventually, the loss of a limb. Because of the common and seemingly harmless nature of initial symptoms it is important to be checked for PAD if you have risk factors. At times, PAD does not even exhibit symptoms, making periodic checks very important for those with risk factors.
First, it is necessary to determine if you are at risk for PAD. Those who smoke, have diabetes, high blood pressure, or cholesterol are at higher risk. In addition, the risk increases with age and there is an increased prevalence in the black community. Other common symptoms include leg pain that doesn’t go away, foot wounds that take longer to heal, if they heal at all, and a difference in temperature between your lower leg and the rest of your body.
If you feel you may be at risk, regardless of whether or not you are experiencing symptoms, testing is a valuable precaution. The first thing your doctor may do, in the course of a regular examination, will be to check your leg for a weak pulse. The doctor may also perform the ankle-brachial index test, which simply compares the blood pressure in your arm to that in your feet. If there is a significant difference between the two the doctor may order one of a few tests:
• Doppler and Ultrasound imaging: which involves using sound waves to measure blood flow and indicate blockage.
• Computed Tomographic Angiography: which shows the doctor arteries in the abdomen, pelvis and legs.
• Magnetic Resonance Angiography: works like the CTA, but without using x-rays.
• Angiography: not likely as a preliminary test, but your doctor may use this test which involves injecting a contrast agent to make the x-rays of your arteries easier to read.
Should you be diagnosed with PAD, there are several treatment options available. Since many of the causes result from lifestyle choices, many treatments involve lifestyle changes. According to the AHA, the most effective treatment for early PAD is exercise. Your doctor can recommend an exercise regimen for you that will be sensitive to the leg pain caused by PAD while still working to diminish the PAD.
Your diet is also important. As PAD is often caused by high cholesterol and obesity, maintaining a healthy diet is a good way to prevent as well as treat PAD. Your doctor can help you make good dietary choices, and there are also medications available to help reduce cholesterol levels.
Smokers generally develop PAD ten years before non-smokers so, if you smoke, expect to be asked to quit, as this will help greatly to decrease the effects of PAD and other heart-related issues.
Your doctor may also prescribe various medications to treat the causes of PAD. Whether blood pressure and cholesterol medicines or medicine for blood clots, it is extremely important that you follow your doctor’s directions in taking these medications. Not doing so can also increase your risk for heart attack or stroke.
For some patients these treatments will not be enough and surgery may be necessary. These procedures may involve inserting balloons or wire cylinders in to the artery to open it up or using another vein to bypass the artery all together. Whatever the case, your doctor can discuss these options with you further.
Since peripheral arterial disease is associated with increased rates of heart attack and stroke, as well as other serious health complications, it is important to be checked regularly by your doctor if you may be at risk. A healthy diet and exercise are also important in preventing PAD and you should ask your doctor if you have any questions.
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