Peripheral Vascular Disease
What is peripheral vascular disease (PVD)?
- Peripheral vascular disease (PVD) is a disorder of leg arteries secondary to their narrowing and blockages which may lead to difficulty in walking, gangrene, non-healing ulcers which may eventually end up in amputation. PVD is the most common cause of non-traumatic leg amputation in the world.
- Blockages occur when fatty (cholesterol) material also called as “plaque” builds up on the walls of your arteries making them narrower. This process is known as Atherosclerosis. It is similar to coronary artery disease (CAD) which leads to blockages in heart arteries causing heart attack. Like heart attack, peripheral vascular disease is also known as “Limb attack”.
Risk factors for atherosclerosis causing peripheral vascular disease
- Age (especially older than age 50)
- Diabetes mellitus
- Smoking (or use of other tobacco products)
- High blood pressure (Hypertension)
- High blood cholesterol
- Obesity
- Physical inactivity.
- History of heart disease
Diabetics and smokers have the highest risk of complications from PVD.
What are the symptoms of peripheral vascular disease?
The most common first symptom is painful leg cramping that occurs with walking and is relieved by rest (intermittent claudication). During rest, the muscles need less blood flow, so the pain disappears. It may occur in one or both legs depending on the location of the clogged or narrowed artery.
Figure 2 : Intermittent claudication, pain in calf on walking
As the disease progress, it leads to
- Rest pain: pain in the foot at night while lying flat.
- Gangrene (dead tissue due to lack of blood flow)
- Wounds that won't heal over pressure points, such as heels or ankles
- Reddish-blue discolouration of the extremities.
- Impotence
Vascular surgery —a bypass graft using a blood vessel from another part of the body or a tube made of synthetic material is placed in the area of the blocked or narrowed artery to reroute the blood flow
Can I prevent peripheral vascular disease?
To prevent PVD, take steps to manage the risk factors. A prevention program for PVD may include:
- Quit smoking.
- Exercise 30 minutes or more daily
- Control of diabetes
- Control of high blood pressure
- Dietary changes including reduced fat, cholesterol, and simple carbohydrates (such as sweets), and increased amounts of fruits and vegetables, low-fat dairy,
- Treatment of high blood cholesterol.
- Weight reduction.
- Medicine to reduce your risk for blood clots, as determined by your healthcare provider.
What are diabetic foot ulcers?
- Diabetic foot ulcers: are non-healing wounds in foot or ankle which may lead to loss of limb or life. Ulcers usually begin with an injury or a shoe bite. Diabetic patient’s having raw area on foot which is non-healing and draining pus should consult doctor or early basis.
- Diabetic neuropathy is most common complications of diabetes which contribute towards development of diabetic foot ulcers. When leg’s nerves get damage, diabetic neuropathy occurs. Diabetic neuropathy symptoms may be either tingling feeling or the loss of feeling in your feet.
- Neuropathy usually starts from the both side of toes and progresses up to the legs. Even walking style may change due to diabetic neuropathy and eventually feet shape may get change. These changes further increase the risk of ulceration.
- Up to 50% of ulcerations in people living with diabetes are thought to be related to diabetic neuropathy alone, rest are mostly due to PVD.
Key points about peripheral vascular disease
- Blood flow is restricted to the leg muscle because of narrowing or blockage of the vessel.
- The most common symptom is pain, which becomes worse as the circulation more limited.
- Restoring blood flow and preventing disease progression is the goal of treatment.