Low blood circulation usually indicates arteriosclerosis, or hardening of the arteries. Atherosclerosis dominates as the most common type of arteriosclerosis. This disease involves stiffening and narrowing of medium and large arteries due to fat-rich deposits called plaques. As plaques grow, blood flow diminishes to areas supplied by involved arteries. Atherosclerosis typically affects multiple arteries in the body, but the rate of progression often varies among the involved arteries. This is affected by several factors, including a smoking, diabetes and genetic factors. Signs and symptoms of poor blood circulation due to atherosclerosis vary depending on the areas most severely affected, which includes the heart, brain and legs, among others.
Peripheral Artery Disease Signs and Symptoms
Peripheral artery disease (PAD) refers to atherosclerosis of the extremities. PAD usually affects the legs. The arms are rarely involved. Poor circulation related to PAD can cause a variety of signs and symptoms, including:
-- heaviness, muscle cramps or pain in the legs when walking or climbing stairs that goes away with rest
-- paleness of the feet when elevated
-- redness of the feet when the body is upright
-- cool, thin, dry skin on the feet and lower legs
-- loss of hair on the lower legs and toes
-- decreased rate of toenail growth
-- weak or absent pulses in the feet
-- slow healing of cuts and scrapes on the legs
With severe PAD, leg pain may persist even at rest. Muscle weakness can limit the ability to walk. Additionally, nonhealing ulcers can develop. Numbness also commonly occurs with severe PAD. People with severe PAD are at risk for gangrene, particularly of the toes. Gangrenous tissue is cold, lacks feeling and initially appears grey, blue or purple in color, followed by subsequent darkening to brown or black.
Coronary Atherosclerosis Signs and Symptoms
Coronary atherosclerosis, also known as coronary artery disease (CAD), is the leading cause of heart disease among Americans. As with atherosclerosis in other arteries, symptoms typically do not develop until circulation reaches a critically low level. Some people with CAD develop stable angina, in which temporary chest discomfort predictably occurs when the heart's workload increases due to physical exertion or emotional distress. Chest discomfort, typically described as a crushing sensation or ache, occurs due to a transient deficiency in oxygen delivery to the heart that is relieved by rest. Shortness of breath may accompany chest discomfort. Angina is not a heart attack but people with CAD-related angina are at high risk for a heart attack. Worsening angina, angina at rest, fatigue and worsening shortness of breath often occur in the days to weeks leading up to a heart attack.
Unfortunately, many people with CAD experience no symptoms until a complete blockage of a coronary artery occurs, triggering a heart attack. Possible signs and symptoms of an impending or evolving heart attack include:
-- chest pain or discomfort that often radiates to the arm, shoulder, jaw and/or back
-- shortness of breath
-- cold, clammy skin
-- nausea and vomiting, particularly among women
-- pounding, irregular or fast heart rate
-- lightheadedness, dizziness or fainting
Cerebrovascular Atherosclerosis Signs and Symptoms
Roughly 80 percent of strokes occur due to atherosclerosis. Poor brain circulation typically causes no symptoms until a transient ischemic attack (TIA), commonly known as a mini-stroke, or a full-blown stroke occurs. A TIA occurs when a transient blood flow obstruction causes lack of oxygen in the brain but no permanent damage. With a stroke, the blood flow obstruction persists long enough to permanently damage part of the brain. Symptoms of TIA and stroke overlap. However, TIA symptoms last less than an hour, usually resolving completely within 30 minutes. People who experience a TIA are at high risk for a stroke in the following hours to days.
Headache sometimes precedes a TIA or stroke. Symptoms of TIA and stroke usually occur suddenly but sometimes evolve over several hours. Possible signs and symptoms and include:
-- tingling, numbness, weakness or paralysis of the arms or legs, usually affecting one side of the body
-- tingling, numbness or drooping of one side of the face
-- slurred speech, loss of ability to speak, or difficulty understanding others
-- dizziness, a spinning sensation, or loss of balance or coordination
-- involuntary eye movements, double vision, or loss of vision in one or both eyes
-- confusion, decreased consciousness or loss of consciousness
Warnings and Precautions
Call 911 without delay if you experience any signs or symptoms that might indicate a heart attack, TIA or stroke. Every minute counts in terms of limiting permanent damage and possibly saving your life.
Seek medical care as soon as possible if you experience signs or symptoms suggestive of PAD. Early treatment can lead to reduced symptoms and progression. Additionally, since people with PAD typically have atherosclerosis in other arteries, evaluation and treatment may reduce your risk for a heart attack or stroke.
Reviewed and revised by: Tina M. St. John, M.D.