Poor blood circulation is caused by peripheral arterial disease. According to "Harrison's Principles of Internal Medicine," the most common underlying cause is atherosclerosis, which means hardening of the arteries. Peripheral arterial disease most often appears in the 60s and 70s. Risk factors include diabetes, smoking, high blood pressure and high cholesterol. Though peripheral arterial disease causes uncomfortable symtoms, it is less likely to lead to serious illness and death than the other conditions associated with atherosclerosis--heart disease and strokes.
Pain and Cramping
According to "Harrison's Principles of Internal Medicine," intermittent claudication is the most common symptom of peripheral arterial disease. Symptoms consist of pain and cramping in the muscles, occurring during exercise, and relieved by rest. Symptoms appear most often in the lower limbs and can make it hard to walk, even for short distances. Pain usually occurs in the calves, and can appear in the hips or thighs, especially after climbing stairs. If the disease worsens, pain can appear when lying down and can interfere with sleep.
Other Chronic Symptoms
The pulse in the affected limbs is weak or absent. Skin becomes shiny and smooth, hair loss occurs and nails are thickened. The affected leg feels cold to the touch and appears pale or bluish. Muscle atrophy can occur, resulting in thin legs with a wasted appearance. Men can suffer from erectile dysfunction. Peripheral artery disease also limits the supply of blood to the peripheral nerves. Symptoms include numbness and reduced reflexes.
Ulcers and Gangrene
If the leg is injured or develops an infection, healing is impaired due to the reduced blood flow. Ulcers and gangrene may develop, making it necessary sometimes to amputate a limb. According to "Harrison's Principles of Internal Medicine," about 1 to 2 percent of patients develop these severe symptoms, known as critical limb ischemia. Out of these patients, about 1/3 survive.
References
- "Harrison's Principles of Internal Medicine, 17th edition"; Anthony Fauci et al.; 2008
- Mayoclinic.com: Peripheral Artery Disease
