Peripheral Arterial Disease also known as peripheral vascular disease commonly abbreviated as PAD or PVD. Peripheral vascular disease affects approximately 8 million Americans annually. Peripheral vascular disease is the result of a narrowing of the blood vessels from the heart to the legs resulting in decreased blood flow to the feet. One of the greatest contributors to this problem is a build-up of fatty plaques in the blood vessels known as atherosclerosis.
How to decrease your risk of PAD and ischemic ulcers: Think of your ABCDEs
- A1c – Watch your hemoglobin A1c, a blood test that determines long-term (3-month) glucose control
- BP – Keep your blood pressure within the normal range
- Cholesterol – Maintain a normal levels of “bad” cholesterol, called LDL
- Diet – Body Mass Index (BMI) above 25 increases your risk of cardiac disease and diabetes
- Exercise – Walk or bike regularly
- Smoking – Decrease or quit tobacco usage
What does PAD look like?
From a visual perspective the at risk foot may appear red, cool, dry and hairless, shiny and even feel numb, indicating decreased blood flow to the feet. Should problems with blood flow progress, this may result in a non-healing wound or sore. Sometimes this sore becomes a painful, punched-out-appearing hole or ischemic ulcer in the toes or feet, and is often very painful to touch and does not seem to get better. In more severe cases the foot may even turn shades of gray or black indicating an emergent situation requiring emergency medical care. This is known as Gangrene.
On closer physical examination performed by a medical professional, the at-risk foot may have an absence of pedal pulses in the feet and or lower extremity indicating a more serious problem with circulation and may necessitate the need for medical attention and care. Initial testing and assessment may involve a non- invasive ultrasound or Arterial Doppler to assess the blood flow to the legs. If more information is needed about circulation status and angiogram or CT scan may be performed by your vascular surgeon or cardiologist.
Symptoms of PVD may include rest pain or claudication pain. Rest pain is a pain that occurs in the evening and often awakens an individual from sleep due to leg pain. The individual typically receives relief by dangling the legs over the edge of the bed. This is different from a muscle cramp in that its intensity is much greater. By comparison, claudication pain is a pain that occurs when an individual attempts to walk approximately one to two blocks and experiences leg, calf or buttock, hip or thigh pain that is severe enough to cause the patient pain and relieved by rest and when walking is reinitiated, the pain recurs.
Similar to non healing wounds and gangrene, rest pain and claudication pain are serious conditions in which the body is in essence starving for oxygen. All of these are conditions that require discussion with your primary care physician , podiatrist and an appropriate and timely consultation with a vascular surgeon without delay.
