Peripheral Vascular Disease
|Area of pain||Symptoms|
|legs||reduced hair growth, cramps when lying in bed|
|legs and arms||turn reddish blue or pale|
|legs and feet||thin or pale skin, weak pulses, wounds, or ulcers that won’t heal|
|toes||blue color, severe burning, or thick and opaque toe nails|
|muscles||feel numb or heavy|
Tell your doctor if you’re experiencing any symptoms of PVD. These symptoms are commonly brushed aside as the results of aging, but delayed diagnosis and treatment can cause further complications. In extreme cases of blood loss, gangrene, or dead tissue, can occur. If you suddenly develop a cold, painful, pale limb with weak or no pulses, this is a medical emergency. You will require treatment as soon as possible in order to avoid severe complications and amputation.
The most common symptom of PVD and PAD is claudication. Claudication is lower limb muscle pain when walking. You may notice the pain when you are walking faster or for long distances. It usually goes away after some rest. When the pain comes back, it may take the same amount of time to go away.
Claudication occurs when there’s not enough blood flow to the muscles you’re using. In PVD, the narrowed vessels can only supply a limited amount of blood. This causes more problems during activity than at rest.
As your PAD progresses, symptoms will occur more frequently and get worse. Eventually, you may even experience pain and fatigue during rest. Ask your doctor about treatments to help improve blood flow and decrease pain.
Complications from undiagnosed and untreated PVD can be serious and even life-threatening. Restricted blood flow of PVD can be a warning sign of other forms of vascular disease.
Complications of PVD can include:
- tissue death, which can lead to limb amputation
- pale skin
- pain at rest and with movement
- severe pain that restricts mobility
- wounds that don’t heal
- life-threatening infections of the bones and blood stream
The most serious complications involve the arteries bringing blood to the heart and brain. When these become clogged, it can lead to heart attack, stroke, or death.
Early diagnosis is the first step to successful treatment and it can prevent life-threatening complications.
Tell your doctor if you have any of the classic symptoms of PVD, such as claudication. Your doctor will also ask about your medical history and perform a physical exam. The physical exam can include measuring the pulses in your legs and feet. If your doctor hears a whooshing sound through their stethoscope, it could mean a narrowed blood vessel.
They may order more specific tests to diagnose PVD. These tests include:
|Doppler ultrasound||sound waves for imaging||blood flow in your vessels|
|ankle-brachial index (ABI)||ultrasound and blood pressure cuff around your ankle and arm, measured before and during exercise||comparison of blood pressure readings in your leg and arm, as lower pressure in your leg could indicate a blockage|
|angiography||injected dye in a catheter that’s guided through the artery||the flow of dye through blood vessels to diagnose the clogged artery|
|magnetic resonance angiography (MRA)||magnetic field imaging||image of blood vessels to diagnose blockage|
|computerized tomography angiography (CTA)||X-ray imaging||image of blood vessels to diagnose blockage|
The two main goals of PVD treatment is to stop the disease from progressing and to help you manage your pain and symptoms so you can remain active. The treatments will also lower your risk for serious complications.
First-line treatment typically involves lifestyle modifications. Your doctor will suggest a regular exercise program that includes walking, a balanced diet, and losing weight.
If you smoke, you should quit. Smoking directly causes reduced blood flow in vessels. It also causes PVD to get worse, as well as increasing your risk of heart attack and stroke.
If lifestyle changes alone aren’t enough, you may need medication. Medications for PVD include:
- cilostazol or pentoxifylline to increase blood flow and relieve symptoms of claudication
- clopidogrel or daily aspirin to reduce blood clotting
- atorvastatin, simvastatin, or other statins to lower high cholesterol
- angiotensin-converting enzyme (ACE) inhibitors to lower high blood pressure
- diabetes medication to control blood sugar, if you have diabetes
Significant artery blockages may require surgery like angioplasty or vascular surgery. Angioplasty is when your doctor inserts a catheter or long tube into your artery. A balloon on the tip of the catheter inflates and opens up the artery. In some cases, your doctor will place a small wire tube in the artery, called a stent, to keep it open.
Vascular surgery allows for blood to bypass the narrow area through vein grafting.
If diagnosed early, many cases of PVD will respond to lifestyle treatments. One way to measure improvement is to measure how far you can walk without pain. With effective treatment, you should be able to gradually increase the distance.
Contact your doctor if your symptoms get worse or you experience any of the following:
- legs look pale or blue
- legs become cold
- chest pain accompanies leg pain
- legs become red, swollen, or hot
- new sores or ulcers develop and do no heal
- fever, chills, weakness, or other signs of infection
How PVD impacts people around the world
You can reduce your risk of developing PVD through a healthy lifestyle. This includes:
- avoiding smoking
- controlling your blood sugar, if you have diabetes
- setting an exercise goal of 30 minutes a day, five times a week
- working to lower cholesterol and blood pressure
- eating a healthy diet that’s low in saturated fat
- keeping your weight at a healthy level
Talk to your doctor if you experience symptoms of PVD. Early diagnosis can help you and your doctor find ways to reduce your symptoms and increase the effectiveness of your treatment.
Medically Reviewed by: Judith Marcin, MD
Published By: Healthline Networks, Inc.