Peripheral Artery Disease (PAD)
PAD is a blockage in the circulation to the arms or legs due to atherosclerosis or other disease. It may lead to limb loss, stroke, heart attack and/or sudden death. Most people are not aware that they have it until it is too late.
It’s important to learn about the factors that may put you at risk for PAD and to proactively be checked for blockages. Taking proactive steps can help save your limbs or even your life.
The most common symptoms of PAD are cramping, tingling in the extremities or pain or fatigue in the leg, calf or hip muscles while walking or exercising. Typically, this pain disappears with rest and returns when you walk or exercise again.
What You Should Know About PAD
- Many people mistake the symptoms of PAD for something else
- PAD often goes undiagnosed by health care professionals
- People with peripheral vascular disease have four-to-five times more risk of heart attack or stroke.
- Left untreated, PAD can lead to gangrene and amputation
You are at especially high risk for PAD if you smoke, live a sedentary lifestyle, have a family history of PAD, are obese, diabetic or have high cholesterol or blood pressure.
Treatment for peripheral arterial disease (PAD) focuses on reducing symptoms and preventing further progression of the disease. In most cases, lifestyle changes, exercise and claudication medications will slow or halt the progression or symptoms of PAD.
Abdominal Aortic Aneurysm (AAA)
An abdominal aortic aneurysm occurs when the large blood vessel that supplies blood to the abdomen, pelvis and legs becomes abnormally large or balloons outward. The exact cause is unknown, but risk factors for developing an aortic aneurysm include:
- High blood pressure
- High cholesterol
- Male gender
- Genetic factors
An abdominal aortic aneurysm can develop in anyone but is most often seen in males over 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to rupture.
Aneurysms develop slowly over many years and often present no symptoms. If an aneurysm expands rapidly or tears open, or if blood leaks along the wall of the vessel, symptoms may develop suddenly.
These may include:
- Pain in the abdomen or back — severe, sudden, persistent or constant. The pain may radiate to the groin, buttocks or legs.
- Clammy skin
- Nausea and vomiting
- Rapid heart rate
Surgery is sometimes recommended for patients who have aneurysms. A surgeon may recommend checking the size of the aneurysm with a yearly ultrasound test to see if the aneurysm is enlarging before doing surgery.
Anyone with pain in the belly or back that does not go away or is very severe should go to the emergency room or call 911.
Atherosclerosis is a condition in which fatty material collects along the walls of arteries and can affect many parts of the body, including the heart, lungs, brain, intestines, kidneys and limbs.
If the coronary arteries narrow, blood flow to the heart can slow or stop, causing chest pain, shortness of breath, heart attack and other symptoms.
Risk factors for atherosclerosis include diabetes, heavy alcohol use, high blood pressure, high cholesterol, a high-fat diet, increasing age, obesity, personal or family history of heart disease, and smoking.
Symptoms usually do not occur until blood flow becomes restricted or blocked, so it's important to get vascular screenings if a person has risk factors. Symptoms can include:
- Abdominal aortic aneurysm
- Coronary artery disease
- Kidney disease
- Mesenteric artery ischemia
- artery disease
- Renal artery stenosis
- Thoracic aortic aneurysm
A number of surgeries are commonly performed to help reduce the complications of atherosclerosis. Some of these are:
- Angioplasty and stent
- Angioplasty and stent placement - peripheral arteries
- Abdominal aortic aneurysm repair - open
- Coronary artery bypass surgery
- Carotid artery surgery
- Minimally invasive heart surgery
Carotid Artery Disease
The carotid arteries provide the main blood supply to the brain. They are located on each side of the neck under the jaw line. Carotid artery disease is a condition in which these arteries become narrowed or blocked. This narrowing or blockage occurs when sticky, fatty substances called plaque buildup in the inner lining of the arteries.
The plaque may slowly block or narrow the carotid artery or cause a clot to form. Clots can lead to stroke.
Risk factors for blockage or narrowing of the arteries include:
- High blood pressure
- Heart disease
- High cholesterol
- Heavy alcohol use
- Kidney disease, especially when dialysis is needed
- Cocaine abuse
- Family history of stroke
- Increasing age
Two uncommon conditions, Marfan syndrome and fibromuscular dysplasia (abnormal growth or development of the cells in the walls of carotid arteries), may also cause narrowing of the carotid arteries.
Individuals may not have any symptoms, or they may have symptoms of a stroke or a transient ischemic attack (TIA). Some of these symptoms include:
- Weakness in one part of the body
- Blurred vision
- Loss of memory
- Problems with speech and language
- Loss of sensation
Treatment options may include:
- Testing the carotid arteries every year
- Medicine and diet to lower cholesterol and control blood pressure
- Blood-thinning medicines to lower the risk of stroke
Surgery, called carotid endarterectomy, to remove the buildup in the carotid arteries may help prevent new strokes from occurring in persons with large blockages in their neck arteries.
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