Peripheral Vascular Disease 

Not all cardiovascular conditions are felt as chest pain. Other parts of the body may start showing signs of cardiovascular disease. For instance, peripheral artery disease (PAD), a type of peripheral vascular disease (PVD), can be felt as leg and buttock cramps, which may go away with rest. However, up to 4 in 10 people with PAD do not experience leg pain. With PAD, aches, cramps or discomfort while walking can occur in the thigh, hip or calf. 

What Is the Difference Between PAD and PVD? 

Peripheral vascular disease (PVD) is an umbrella term that includes PAD, lymphatic disease and peripheral venous disease. It is often used interchangeably with PAD. The American Heart Association recommends the term PAD to describe a disease affecting the blood vessels outside the heart.

Atherosclerosis is a condition that occurs when there is a buildup of fatty deposits in the arteries, causing them to become narrowed or blocked and preventing the oxygenated blood from reaching the rest of the body. If this condition affects the arteries that supply blood to the arms, legs or feet, it can lead to PAD. As people age, they are at increased risk of developing PAD. Other PAD risk factors include pre-existing conditions like diabetes, high blood pressure, smoking and high cholesterol levels.

Other disorders or conditions affecting the arteries may have symptoms like PAD, but not all PAD is caused by atherosclerosis. People with PAD are at risk of developing cerebrovascular and coronary artery disease, which could lead to stroke or heart attack. Atherosclerosis can affect other arteries in the body. This condition has different names depending on which arteries are affected:

Type of AtherosclerosisAffected Arteries
Coronary artery disease (CAD)Heart
Carotid artery diseaseNeck
Renal artery stenosisKidneys
Vertebral artery diseaseBack of the brain
Mesenteric artery IschemiaIntestines

Types of Peripheral Vascular Disease 

  • Occlusive PVD – caused by blockage in the blood vessels.
    • Atherosclerosis – the buildup of fatty deposits (plaque) in the arteries. It can result in narrowed arteries and reduce blood flow through them. Buerger’s disease – involves swelling of the blood vessels, preventing blood flow and causing clot formation. It can lead to tissue damage, pain and even gangrene.
    • Carotid artery disease – the narrowing of the carotid arteries, the main blood vessels carrying oxygenated blood to the brain.
    • Deep vein thrombosis – blood clots in the veins found in the leg that can dislodge and travel to the lungs and heart, resulting in pulmonary embolism or blockage of the lung artery
    • Lymphedema – swelling of some body parts due to lymph buildup. Lymph is a fluid in the lymphatic system traveling through the body to fight disease.
  • Functional PVD – blood vessels narrow and widen due to other factors, such as stress, cold temperatures, smoking or work involving vibrating tools.
    • Chronic venous insufficiency (CVI) - blood pooling in the legs because the vein valves do not work properly, preventing blood from the legs from returning to the heart.
    • Raynaud’s disease – arteries spasm and temporarily restrict blood flow
    • Varicose veins – enlarged, twisted veins visible under the skin and caused by venous insufficiency.

What Are the Warning Signs of Peripheral Vascular Disease? 

Working muscles need more blood than muscles that are not active. When someone has PVD, they can get leg cramps when they walk, work out or go upstairs. This pain means the muscles are not getting enough blood. Some people with PVD may think their pain is from something else or they might not feel any pain at all. Other PVD or peripheral artery disease symptoms are:

  • The affected leg or foot has a lower temperature than the rest of your body
  • Toe or foot wounds that heal very slowly or do not heal
  • Thickened, opaque toenails
  • Shiny skin on the leg
  • Poor toenail growth
  • Muscle weakness, numbness or heaviness
  • Impotence
  • Gangrene
  • Decreased leg hair growth
  • A bluish or pale color to the skin

How Is Peripheral Vascular Disease Diagnosed? 

Do not ignore it if you experience persistent leg pain or cramps when exercising. Abnormal swelling in your legs and feet may also be signs of a more serious problem, as well as the other symptoms mentioned earlier. Consult your doctor for a proper diagnosis if you experience pain or other unusual symptoms.

To help diagnose PVD, tell your healthcare provider about your symptoms, risk factors, and personal and family health or medical history. You also must disclose if you have been diagnosed with other medical conditions. Your doctor may perform several diagnostic procedures such as the following to diagnose PVD:

  • Ankle-brachial index - comparing the blood pressure in the ankle with the blood pressure in the arm
  • Computed tomography angiography (CTA) - a form of imaging that uses a dye injected into the blood vessels to allow the doctor to watch blood flow through the arteries more clearly.
  • Doppler ultrasound - the use of sound waves to show blood flow through blood vessels
  • Magnetic resonance angiography – the use of radio waves, a computer and a powerful magnetic field to evaluate blood vessels
  • Peripheral angiography - the use of contrast dye and X-rays to identify narrowed or clogged arteries that supply blood to your limbs

What Is the Life Expectancy of Peripheral Vascular Disease? 

Life expectancy depends on a range of factors, such as the severity of the PVD by the time it was diagnosed, the patient’s overall health, other existing health conditions and many more. In general, people with PVD, regardless of whether they experience symptoms or not, are at an increased risk of stroke, heart attack and thrombosis. As such, patients with PVD should undertake lifestyle changes and other adjustments to help lower their risk of complications.

Can Peripheral Vascular Disease Be Cured? 

Currently, there is no specific cure for PVD. Peripheral vascular disease treatment aims to reduce symptoms and prevent them from worsening. Lifestyle changes, prescribed medications and exercise may be able to help.

  • Stop smoking – smoking is a major PAD factor and increases your risk for stroke and heart attack. Work with us to discover programs and medications that may help you quit smoking.
  • Physical activity – our rehabilitation program includes a supervised exercise routine you can do to help ease symptoms. Simple leg exercises, walking regimens and treadmill workouts can help, too.
  • Diet – aim for a diet low in trans-fat and saturated fat to lower your blood cholesterol levels. Emphasize fruits, vegetables and whole grains in your diet while including low-fat dairy, fish, legumes and more.
  • Medication – prescribed medications may include:
    • Anti-platelets to prevent blood clots
    • Medications to lower cholesterol
    • High blood pressure medications

     

Peripheral Vascular Disease Surgery 

Minimally invasive treatment or peripheral vascular surgery may be recommended if nonsurgical treatments do not improve a patient’s symptoms. Here are some procedures that may be performed:

  • Angioplasty or stent placement – procedures that involve making a small incision where a catheter will be inserted to reach the clogged artery. A tiny balloon will be inflated to open the blocked artery.
  • Atherectomy – a minimally invasive procedure to remove plaque blocking the artery. A catheter with a cutter at the end will be inserted to cut and remove the plaque from the blood vessel.
  • Bypass surgery – if a patient experiences severe symptoms and an extended portion of their leg blood vessel is completely blocked, bypass surgery may be needed, especially if other minimally invasive techniques are no longer possible. Bypass surgery is a peripheral vascular surgery that aims to reroute blood flow around the clogged artery using a vein taken from another part of the patient’s body.

Your Heart Is in Good Hands

Baptist Medical Network is your heart and vascular care destination in San Antonio, TX. We are committed to helping you understand your condition to get the care you need.

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