Conditions We Treat: Peripheral Vascular Disease
Peripheral vascular disease (PVD) is a blood circulation disorder in which the blood vessels outside of the heart and brain become narrowed or blocked, or frequently spasm. The disorder can occur in the arteries or veins that supply blood to the legs, arms, kidneys, stomach or head. Most commonly, it's a narrowing of the arteries in the legs or arms caused by plaque buildup.
There are two main types of PVD:
- Functional PVD, in which there's no physical defect or damage to the structure of your blood vessels. Instead, the vessels spasm — narrow or widen beyond what is normal — in response to stimuli such as brain signals and temperature changes. The narrowing causes your blood flow to decrease. Raynaud's disease is an example of functional PVD.
- Organic PVD, in which the structure of your blood vessels is changed or damaged due to atherosclerosis, which is plaque buildup and inflammation. Organic PVD is similar to coronary artery disease (CAD).
Peripheral artery disease (PAD) is the most common type of organic PVD. It's usually caused by atherosclerosis in the inner walls of the arteries, which blocks normal blood flow. The term "peripheral vascular disease" is often used to mean "peripheral artery disease."
Common risk factors for PAD include:
- High blood pressure
- High cholesterol
- Advancing age, especially over 50
- A family history of PAD, heart disease, or stroke
Some people with PAD don't experience any symptoms. For others, the disease begins with a common symptom called intermittent claudation, which is pain or cramping in the legs or arms that's triggered by activity and stops with rest. Claudication varies from mild discomfort to debilitating pain. Severe claudication can prevent people from walking or doing other types of physical activity.
If poor circulation affects the kidneys, it can cause sudden high blood pressure or even loss of kidney function.
Other common symptoms of PAD include:
- Leg numbness or weakness
- Coldness in your lower leg or foot, especially when compared with the other side
- Numbness, weakness or heaviness in the legs or feet
- Thin, brittle or shiny skin on the legs or feet
- Diminished pulses in the legs or feet
- Hair loss on the legs
- Slow growth of toenails
- Impotence in men
- Reddish-blue discoloration of extremities
If left untreated, PAD can lead to gangrene or amputation. People with PAD are also at higher risk for heart attack and stroke.
Unfortunately, many people mistake the symptoms of PAD for something else, and it can go undiagnosed by medical professionals. But the disease can be easily identified by your doctor using a simple exam called ankle-brachial index (ABI) that compares the blood pressure in your feet to the blood pressure in your arms. If you're at risk for PAD, discuss this with your doctor.
If you're diagnosed with PAD, your doctor might recommend one or more of the following treatments or lifestyle changes:
- Stopping smoking
- Beginning a supervised exercise program
- Eating a healthy diet
- Managing the symptoms of claudication using medications that increase blood flow to the limbs
- Taking cholesterol-lowering medications to reduce the risk of heart attack and stroke
- Taking medication to lower blood pressure if necessary
- Controlling blood sugar if you have diabetes
- Angioplasty or surgery to repair damaged arteries that are causing pain
Treatments such as these can help you stabilize and even improve PAD.