Definition

Peripheral vascular disease (PVD) is a general term for disease of any blood vessel that is not part of the heart [4] or brain [5]. The arterial form, usually referred to as PAD, is caused by deposits of fatty material (atheroma) in arteries of the legs. Since arteries carry oxygen-rich blood to the cells of the body, restriction of this blood flow can cause bodily organs to fail.

This is a potentially serious condition that requires care from your doctor. The sooner PAD is treated, the more favorable the outcome. If you suspect you have this condition, contact your doctor.

Causes

PAD is usually caused by a gradual buildup of plaque within the arteries ( atherosclerosis [6] ). Other causes include blood clots or embolisms, congenital heart [4] disease, and inflammation of the blood vessels (vasculitis).

PAD can be hereditary. More commonly, you may get PAD if you are overweight or obese [7] , or have high blood pressure [8] , diabetes [9] , or high cholesterol [10] . Unhealthy lifestyle choices such as smoking, eating a high-fat diet, and not exercising enough frequently lead to PAD.

Risk Factors

The following factors increase your chance of developing PAD. If you have any of these risk factors, discuss them with your doctor:

• Diabetes [9]
• Cigarette smoking
• High blood pressure [8] (or family history)
• Coronary heart [11] disease (or family history)
• Stroke [12] (or family history)
• High cholesterol [10] (or family history)
• Age over 50
• High homocysteine level in blood
• Gender: Male
• Family history of PAD

Symptoms

Symptoms of PAD are related to the organ or part of the body deprived of adequate circulation. This includes:

• Claudication—pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s) brought on by exercise [13] that goes away when resting, in mild disease
• Numbness and pain [14] of the legs or feet at rest in more severe disease
• Cold hands, legs, or feet
• Loss of hair [15] on the legs and/or feet at night
• Paleness or blueness of the legs
• Weak or absent pulse in the leg
• Sores, ulcer, or infection of the feet and legs that heal slowly
• Erectile dysfunction [16]
• Swelling in lower extremities
• Muscle atrophy

Diagnosis

Your doctor will ask about your symptoms and medical [17] history, and perform a physical exam. Tests may include the following:

• Checking the strength of the pulse in the leg arteries
• Listening for a whooshing sound in a leg artery or the abdomen using a stethoscope
• Ultrasound and doppler analysis [18] of the arteries, especially the carotid arteries in the neck which supply the brain [5] with blood
• Checking blood pressure at various points in the leg and comparing it to the normal arm blood pressure
• Blood tests for blood lipids, homocysteine, fasting blood sugar, hemoglobin A1C, oxidative stress [19] marker (eg 8-iso-PGF 2 alpha)
• Treadmill test
• Electrocardiogram (ECG, EKG) [20] —a test that records the heart's activity by measuring electrical currents through the heart [4] muscle [21]
• Angiography [22] of the arteries in the legs (x-rays of blood vessels that have been injected with a dye)
• MRI [23] —a test that uses magnetic waves to make pictures of the blood vessels

Treatment

Early treatment can slow or stop the advancement of the disease. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Prevention

To help reduce your chances of getting PAD, make the lifestyle changes listed above under treatment.