What is peripheral vascular disease?
Peripheral vascular disease (PVD) is a circulatory disorder that causes blood vessels outside the heart and brain to narrow, block, or contract. It can occur in your arteries or veins. The peripheral vascular disease generally causes pain and fatigue, often in the legs and especially when exercising. The pain usually improves with rest.
Signs/symptoms of peripheral vascular disease
People with the peripheral vascular disease do not have any symptoms. Possible symptoms include:
- Hair loss on the feet and legs.
- The thigh or calf muscles may feel pain when walking or climbing stairs, some individuals complain of painful hips.
- Leg weakness.
- A foot or the lower leg may feel cold.
- Numbness in the legs.
- Brittle toenails.
- Toenails grow slowly.
- Sores or ulcers on the legs and feet that take a long time to heal (or never heal).
- The skin on the legs becomes shiny or turns pale or bluish.
- Difficulty in finding a pulse in the leg or foot.
- Erectile dysfunction (impotence in men, problems achieving or sustaining an erection).
Causes of peripheral vascular disease
Peripheral artery disease is often caused by atherosclerosis. In atherosclerosis, fatty deposits (plaques) form on the walls of the arteries and reduce blood flow. Although discussions of atherosclerosis generally focus on the heart, the disease affects arteries throughout the body.
When it occurs in the arteries that supply blood to the organs, it can cause peripheral artery disease. Less commonly, peripheral artery disease can be caused by inflammation of the blood vessels, injury to organs, abnormal anatomy of tendons or muscles, or exposure to radiation.
Risk Factors of peripheral vascular disease
You’re at higher risk for peripheral vascular disease if you:
- Are over age 50
- Are overweight
- Have abnormal cholesterol
- Have a history of cerebrovascular disease or stroke
- Have heart disease
- Have diabetes
- Have a family history of high cholesterol, high blood pressure, or peripheral vascular disease
- Have high blood pressure
- Have kidney disease on hemodialysis
Lifestyle choices that can increase your risk of developing the peripheral vascular disease include:
- Not engaging in physical exercise
- Poor eating habits
- Drug use
Diagnosis of peripheral vascular disease
The differential diagnosis of the peripheral vascular disease includes musculoskeletal and neurological factors. Spinal stenosis also causes compression of each equine, resulting in pain that radiates to both legs. The pain occurs when walking (i.e., pseudocopulation) or standing for a long time and does not subside quickly with rest.
Additional conditions to consider include acute embolism, deep or superficial vein thrombosis, restless leg syndrome, systemic vasculitis, nocturnal leg cramps, muscle or tendon strains, peripheral neuropathy, and arthritis. Some tests your doctor relies on to diagnose peripheral artery disease are:
Physical exam: Your doctor may find signs of peripheral vascular disease on physical examination, a weak or absent pulse below the narrow area of your artery, sounds (fruit) in your arteries that can be heard with a stethoscope, evidence of poor wound healing in an area where your blood flow is restricted and the blood pressure in your affected organ is low.
Ankle-brachial index (ITB): This is a simple test used to diagnose peripheral vascular disease. Compare the blood pressure in your ankle with the blood pressure in your hand. To obtain a blood pressure reading, your doctor will use a simple blood pressure cuff and a special ultrasound device to assess blood pressure and flow. You can walk on a treadmill and take readings before and immediately after exercise to capture the severity of your narrow arteries during your walk.
Ultrasound: Specialized ultrasound imaging techniques, such as doppler ultrasound, can help your doctor evaluate blood flow through blood vessels and identify blocked or narrow arteries.
Angiography: Using a dye (contrast material) inserted into your blood vessels, this test allows you to watch your doctor while watching the flow of blood through your arteries. Your doctor can detect the flow of contrast material using imaging techniques such as X-ray imaging or magnetic resonance angiography (MRA) or computed tomography angiography (CTA).
Catheter angiography: Catheter angiography is a more serious procedure that involves guiding the catheter through the artery in the groin to the affected area and injecting color that way. Despite the aggression, this type of angiography allows simultaneous diagnosis and treatment. After finding the narrow area of the blood vessel, your doctor may inflate it by inserting and inflating a small balloon or by administering medications that improve blood flow.
Blood test: You can use a blood sample to measure your cholesterol and triglycerides and check for diabetes.
Treatments of peripheral vascular disease
Goals of treatment for peripheral arterial disease:
- Relief of pain from intermittent claudication.
- Improve exercise endurance by increasing walking distance before the start of the liner.
- Avoid the development of a complex artery that can lead to foot ulcers, gangrene, and amputation.
- Avoid heart attacks and strokes.
Treatment for peripheral arterial disease includes lifestyle measures, supervised exercises, medications, angioplasty, and surgery.
Changes in lifestyle: Quitting smoking removes a major risk factor for disease progression and reduces the incidence of pain at rest and dissection. Quitting smoking is also important to prevent heart attacks and strokes.
Supervised exercise: Proper exercise allows the muscles to use oxygen more efficiently and accelerates the development of collateral circulation. Clinical trials have shown that regularly controlled exercise reduces symptoms of intermittent claudication and allows people to walk longer before the onset of claudication. Ideally, your healthcare provider should prescribe an exercise program tailored to your specific needs.
Rehabilitation programs can help under the supervision of health professionals, such as nurses or physical therapists. Exercise at least three times a week, with each session lasting no more than 30 to 45 minutes for the best results. Exercise generally involves walking on a treadmill with a monitor until the lining develops; The walking time increases gradually with each session. Patients are also monitored for the development of chest pain or heart rhythm disturbances during exercise.
Complications of peripheral vascular disease
Complications of peripheral vascular disease are often caused by reduced or no blood flow. Such problems can include:
- Amputation (loss of a limb)
- Poor wound healing
- Limited consciousness due to pain or discomfort
- Severe pain in the affected limbs
- Stroke (3 times more common in people with the peripheral vascular disease)
Prevention of peripheral vascular disease
The best way to prevent peripheral vascular disease is to maintain an active and healthy lifestyle:
- Stop smoking: Tobacco smoke is a major risk factor for peripheral vascular disease and your risk of heart attack and stroke. It can help slow the progression of peripheral vascular disease and other heart-related diseases.
- Work to control your blood pressure, cholesterol, and glucose levels. Working with a coordinated health care team and making the lifestyle changes needed to better manage diabetes can reduce organ-related problems.
- Get regular exercise: The most effective treatment for peripheral vascular disease symptoms is regular physical activity. Your doctor may recommend a program of exercise training to monitor for you, also known as cardiac rehabilitation. You need to start slowly, but regular walking rules, leg exercises, and treadmill exercise programs can reduce symptoms.
- Intermittent exercise for cladding: Taking into account the fact that plaque formation causes poor circulation in the arteries of the leg – can lead to gait pain. This program has alternative functionality and increases the amount of time you can walk before the pain starts. It is a good idea to take this exercise program to the rehab center on the treadmill. If going to a rehabilitation center is not possible, your healthcare professional may recommend a structured community or home-based program that best suits your situation. You may want to speak with your doctor to find out which exercise program is right for you.
- Follow a diet low in fat and cholesterol and eat more fruits and vegetables. If you are overweight or behind, plan a weight loss plan with your doctor. Many peripheral vascular disease patients have elevated cholesterol levels. A diet low in saturated and trans fat can help lower blood cholesterol levels, but cholesterol-lowering medications may be needed to maintain proper cholesterol levels.