Peripheral arterial disease (PAD) is the hardening and narrowing of the peripheral arteries caused by plaque and resulting in lack of circulation to muscles and organs. According to the P.A.D. Coalition, this disease affects 8 to 12 million people in the United States. The number actually may be larger because many people live with PAD but don't realize it.
Risk Factors
People who have PAD are six times more likely to die from heart disease than those who do not, according to the P.A.D. Coalition. Many risk factors are similar to those of cardiovascular disease. People who have or think they might have PAD might also have CVD as well. Risk factors include smoking, age (over 50 yrs), diabetes, as well as high cholesterol and high blood pressure. Ignoring these risk factors can lead to heart attack, stroke, foot/leg amputation and death.
Symptoms
The most common symptom of PAD is cramping of the legs (claudication). This is due to the build up of plaque in the arteries, which causes a deficit in oxygen and nutrients to the skeletal muscle. One sign of PAD is cramping and pain in the legs that is present while walking but diminishes with rest. This is called intermittent claudication. According to the Vascular Disease Foundation, patients also may experience weakness or a heavy feeling in the muscles. Other symptoms can be cool spots on the legs or feet, hair loss, pale skin tone and persistent sores on the feet.
No Symptoms
Up to half of patients with PAD have no symptoms to warn them. The Vascular Disease Foundation calls this "silent PAD." This can be more dangerous than having symptoms because there are no warning signs and the severity of the disease can progress to a non-reversible state.
Getting Tested
Several tests can be suggested to help diagnose PAD. Non-invasive testing includes an Ankle Brachial Index (A.B.I), a treadmill stress test, PVR waveform analysis, and ultrasound imaging. If any of these tests show a possibility of constriction, the doctor may follow up with a more invasive test, such as an arteriogram.
Treatment
Depending on how the progression of the disease, several treatment options are available. One of the easiest ways to treat PAD is with healthy lifestyle changes. Patients need to stop smoking, eat a healthy, low fat/low sodium diet and wear proper fitting shoes to diminish the possibilities of foot sores. Diabetics should maintain healthy blood glucose levels. If the disease becomes severe enough, invasive procedures may have to be performed, including stent, angioplasty and bypass surgery.
Exercise Therapy
An exercise prescription is a plan provided by a trained professional (doctor, clinical exercise physiologist) that details a safe exercise program. Its best to exercise in a supervised facility, and therapy can be done in a cardiac rehab facility. The point of the therapy is to exercise to the point of moderate pain before resting. This promotes collateral circulation, which means that more capillaries are being made to get blood to the muscles. Many hospital organizations provide this service or can recommend good programs nearby.
