Wednesday, February 22, 2012
Peripheral Vascular Disease
By Brian R. Rah, M.D.
What is Peripheral Vascular Disease?
Peripheral vascular disease, also known as PVD, is a very common condition which affects millions of people in this country. It is caused by the same atherosclerotic buildup that causes coronary artery disease and heart attacks. Fatty deposits build up along the vessel wall and affects blood circulation. While coronary artery disease affects the heart arteries, some of the more commonly affected peripheral areas are arteries which lead to the legs, arms, kidneys, and neck. Some patients may have both coronary artery disease and PVD as the atherosclerotic process, unfortunately, is usually not confined to just one artery.
What are some of the symptoms of PVD?
--The symptoms of PVD are determined mainly by the artery involved.
--If the artery to the leg is involved you may develop claudication (a dull, cramping pain in the buttocks, hips, thighs, or calf muscles). Usually the discomfort is brought on by walking and relieved by rest. Pain, numbness or tingling in leg, foot or toes; coolness of foot/toes; discoloration of extremities; and sores that do not heal are all signs of possible PVD. Impotence can also be a sign of peripheral vascular disease.
--A common cause of difficult to control hypertension is due to PVD involving the artery to the kidney. This can also cause a progressive worsening of kidney function and may eventually lead to dialysis.
--If the carotid artery (artery to the brain) is involved there is an increased risk of stroke. Learn to recognize the symptoms of a stroke so that quick action can be taken. Sudden numbness or weakness of face, arm, or leg, especially if only on one side of the body; sudden confusion, trouble understanding, or trouble speaking; sudden trouble with vision; sudden trouble with balance or coordination; sudden severe headache. These are all indicators of a possible stroke. If you have one or more of these symptoms of a stroke dial 911 immediately. Early detection of a blockage in the carotid artery is important to help prevent a stroke before you develop symptoms.
How is PVD diagnosed?
PVD can usually be diagnosed easily and painlessly by a thorough physical examination. Simple blood pressure measurements in arm and leg, Doppler ultrasound tests, and MRI are usually used to confirm what is suspected by your symptoms and physical examination.
How is PVD treated?
--Some patients with PVD may be treated with medications. These medications are mainly anti-platelet agents that help keep blood from clotting.
--If medications are ineffective or not enough to relieve the symptoms, then balloon angioplasty usually with stent placement can be performed. A thin tube called a catheter with a deflated balloon is passed to the narrowed segment of the artery. The balloon is then inflated to open up the artery. A thin metal device, called a stent, is then placed to the narrowed segment and deployed to help keep the artery open. This is a minimally invasive procedure and can be done without surgery.
--In some patients, surgery may be needed.
What are the risk factors for developing PVD?
The risk factors for PVD are similar to those for coronary artery disease. Patients with diabetes are especially prone to developing PVD and should be screened frequently. PVD is also dramatically increased in smokers. Other risk factors for PVD include high blood pressure, high cholesterol, and having a history of heart disease.
If you have any further questions regarding peripheral vascular disease or wish to schedule an appointment, please contact Cardiovascular Consultants of Nevada.
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