Peripheral Arterial Disease

Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD) is a common circulatory problem in which narrowed arteries reduce the flow of blood to the limbs.

When developing peripheral arterial disease (PAD), the limbs – usually the legs, do not receive enough blood flow to keep up with demand. This causes the symptoms, especially the foot pain when walking (claudication).

Peripheral artery disease is also likely to be a sign of an accumulation of fat in the arteries (atherosclerosis). This condition can reduce blood flow to the heart and brain, as well as the legs.

Normally, it is possible to treat successful peripheral artery disease by quitting smoking, exercising and eating a healthy diet.

The Symptoms

While many people with peripheral arterial disease have mild or no symptoms, some people suffer from claudication.

Symptoms include muscle pain or cramping in the legs or arms, triggered by activities such as walking, but disappearing after a few minutes of rest. The location of the pain depends on the location of the blocked or narrowed artery. Mild muscle pain is most common.

The severity of persistent leg pain when walking is very different, ranging from mild discomfort to pain. Severe foot pain when constantly can make walking or other types of physical activity difficult.

Peripheral artery disease symptoms include:

→ Sore throat, hip or leg muscles after activity, such as walking or climbing stairs.

→ Legs numb or weak.

→ Cold in the lower part of the foot or foot, especially when compared to other feet.

→ Toe pain, foot or foot injury does not heal.

→ The color change of the legs.

→ Hair or hair growth grows slower on legs.

→ Slow development of toenails.

→ Shiny legs.

→ There is no weak pulse or vein in the legs or feet.

→ Erectile dysfunction in men.

If peripheral arterial disease progresses, pain may even occur while resting or lying down (painful ischemia at rest). It can be powerful enough to break sleep. Hanging feet on the bedside or walking around the room can temporarily relieve the pain.

For leg pain, numbness or other symptoms, do not record them as a normal part of old age. Call your doctor and make an appointment.

Even if there are no symptoms of peripheral artery disease, it may need to be checked if:

→ Over 70 years old.

→ Be over 50 years of age and have a history of diabetes or smoking.

→ Under age 50 but with diabetes and other risk factors for artery disease, such as obesity or hypertension.


Peripheral artery disease is usually caused by atherosclerosis. In atherosclerosis, plaque builds up in the artery walls and reduces blood flow.

Although the heart is usually the focus of discussion of atherosclerosis, this disease can and does not usually affect the arteries throughout the body. When it occurs in arteries that supply blood to the limbs, it causes peripheral artery disease.

Rarely, the cause of the PAD can be inflammation of the blood vessels, damage to the limbs, abnormal anatomy of the ligament or muscle, or exposure to radiation.

Risk factor

→ Factors that increase the risk of developing peripheral arterial disease include:

→ Smoking.

→ Diabetes.

→ Fat.

→ High blood pressure (140/90 millimeters mercury or higher).

→ High cholesterol (cholesterol in the blood more than 240 mg / dL, or 6.2 millimoles / liter).

→ Older age, especially after age 50.

→ Family history of peripheral artery disease, heart disease, or stroke.

→ Excessive homocysteine, a protein that helps build and maintain tissue.

→ Smokers or people with diabetes are at higher risk for peripheral artery disease due to decreased blood flow.


If peripheral artery disease is due to the accumulation of plaque in the arteries (atherosclerosis), there is also a risk of developing:

Ischemia. This condition starts like a non-healing ulcer – traumatic or leg or hand infection. Localized ischemia (CLI) occurs when an injury or infection progresses and can cause cell death (necrosis), sometimes requiring amputation.

Stroke and heart attack. Atherosclerosis is the cause of the signs and symptoms of peripheral arterial disease not limited to the legs. Loads of fat also cling to the arteries that supply the heart and brain.

Tests and diagnostics

In some trials, physicians may rely on the diagnosis of peripheral arterial disease as:

Examination. Doctors may find signs of the PAD during a physical examination, such as absence or weakening of the vein under the narrowed arteries, sound in the arteries may be heard with a stethoscope, evidence of the injury poor blood flow, where blood flow is limited, and decreased blood pressure in the affected limb.

Ankle, arm index (ABI). This is a test commonly used to diagnose PAD. It compares the blood pressure in the ankle to the blood pressure in the arm. To get blood pressure, doctors use pressure belts and a special ultrasound device to measure blood pressure and flow. Can walk on the treadmill and read before and immediately after exercise to grasp the severity of the narrowed artery during walking.

Supersonic. Doppler ultrasonography, for example, can help doctors evaluate the flow of blood through blood vessels and determine whether the artery is narrowed or blocked.

Angiography. By injecting a dye into the bloodstream, this test allows the doctor to see blood flow through the arteries. Doctors can monitor the flow of contrast material, using imaging techniques such as radiography or magnetic resonance imaging (MRA) or computerized tomography (CTA). Catheter angiography is a more invasive procedure, involving catheter conduction through the artery in the groin to the affected area and injection of the dye. Although invasive, this type of imaging permits simultaneous arteriography and diagnosis – finding the narrowed blood vessels and then extending it with angioplasty, using drugs to improve blood flow.

Blood tests. A blood sample can be used to measure triglycerides, cholesterol and to test for diabetes.

Treatments and medications

Treatment of peripheral arterial disease has two main objectives. The first is to manage the symptoms, such as leg pain, to be able to resume physical activity. The second is to prevent the progression of atherosclerosis throughout the body, reducing the risk of heart attack and stroke.

Can accomplish these goals with lifestyle changes. If you smoke, quitting smoking is the most important thing you can do to reduce the risk of complications.

If lifestyle changes are not enough, additional medical treatment is needed. Your doctor may prescribe medications to prevent blood clots, hypotension and cholesterol, pain relief, and other symptoms.

Angioplasty and surgery

In some cases, angioplasty or surgery may be necessary for the treatment of peripheral arterial disease that causes continuous foot pain:


A catheter is inserted through the blood vessel into the affected artery. There, a small balloon on the tip of the catheter will be pumped to re-open the arteries and smooth the obstruction into the artery wall. Your doctor may insert a grid called a stent into the artery to keep it open. Use the same procedure to open the heart arteries.


Doctors can make a bridge using a circuit from another part of the body or a blood vessel made of synthetic fabric. This technique allows the blood to flow through – bypassing the narrowed or blocked artery.

Thrombolytic therapy. If blood clots block the arteries, your doctor may inject clot thiamine in the artery at the point of clotting to break it.

Monitor the exercise program

In addition to medication or surgery, your doctor may prescribe an exercise program, supervised to increase walking distance. Regular exercise improves the symptoms of PAD by a number of methods, including helping to use oxygen more effectively.

Lifestyle and remedies

Many people can manage the symptoms of peripheral arterial disease and prevent the progression of the disease through lifestyle changes, especially quitting smoking. To stabilize or improve PAD:

Stop smoking.

Smoking contributes to cramping and damage to the arteries and is an important risk factor for developing PAD and worsening. If you smoke, quitting smoking is the most important thing you can do to reduce the risk of complications.

Do exercise.

This is an important component. Success in the treatment of PAD is usually measured by being able to walk away without pain. Proper exercise helps the muscles use oxygen more effectively. Your doctor can help develop an appropriate exercise plan.

Eat a healthy diet.

A heart-healthy diet low in saturated fat may help control blood pressure and cholesterol levels. Diet rich in nutrients – like vitamins A, B-6, C and E, folate, fiber; and omega 3 fatty acids – associated with a lower incidence of peripheral artery disease.

Some cold medicine.

Cold remedies containing pseudoephedrine (Cold Advil and Sinus, Aleve, Claritin-D, Sudafed, Tylenol, Zyrtec-D, others), vasoconstriction and may increase PAD symptoms.

Foot care

In addition to the above suggestions, care for good feet. People with peripheral arterial disease, especially those who also have diabetes, are at increased risk of ulcers on the legs and feet. Poor blood circulation can delay or prevent proper wound healing and increase the risk of infection. Follow this advice to take care of your feet:

→ Wash your feet daily, thoroughly dry and moisturise regularly to prevent cracks that can lead to infection. No moisturising between the toes, however, as this can encourage mushroom growth.

→ Wear properly fitting shoes and socks.

→ Timely treatment of foot fungal infection.

→ Be careful when you trim your nails.

→ Avoid bare feet.

→ See your doctor when the first signs of a pain or skin injury.

Alternative medicine

The Ginkgo biloba’s blood thinning effect can allow people with leg pain to continuously walk a long distance with less pain. However, this herb can cause bleeding at high doses, and it can be dangerous if combined with antiplatelet drugs, including aspirin. Talk to your doctor before considering using ginkgo biloba to relieve leg pain.

Deal and support

Peripheral artery disease can be very frustrating, especially when exercise is painful. Do not be discouraged, however. As you continue to exercise, you will increase the distance you can walk without pain.

It may be useful to raise the bed head 10 – 15 cm, because keeping the lower leg of the heart usually relieves the pain.

One tip to relieve the symptoms is to avoid cold temperatures as much as possible. If cold can not be avoided, wear warm clothing.

Some people find it helpful to talk to others who are in the same situation. Support groups can encourage, advise. The Heart Association provides an online forum with the PAD.


→ The best way to prevent leg pain is to maintain a healthy lifestyle. It means:

→ Quit smoking if you smoke.

→ If you have diabetes, keep your blood sugar under good control.

→ Exercise regularly. Target 30 minutes at least three times a week after getting OK.

→ Lower cholesterol and blood pressure levels, if needed.

→ Eat foods that are low in saturated fat.

→ Maintain healthy weight.

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