Definition

The human body has a circulatory system, with the heart and blood vessels as its two main components. Blood vessels are classified based on the direction of blood flow: arteries carry blood away from the heart, while veins return it. Arteries deliver blood throughout the body, including to surface areas such as the limbs (arms, hands, thighs, calves, and feet).

Peripheral Artery Disease (PAD) is a condition caused by the narrowing of arteries, typically in the limbs, which restricts blood flow to tissues in these areas.

When you experience problems with peripheral arteries, your arms, hands, thighs, calves, or feet may suffer from reduced blood flow. Blood delivers oxygen and nutrients needed to fuel and nourish organs, ensuring they function properly. When this supply is compromised, symptoms such as leg pain (claudication) during walking can occur.

PAD can also indicate the presence of fat buildup in the arteries, a process known as atherosclerosis. This condition narrows the blood vessels, reducing blood flow, especially to the arms, hands, thighs, calves, or feet. It can often be managed through regular exercise, a balanced diet, and avoiding unhealthy habits like smoking.

Causes

Atherosclerosis is the primary cause of peripheral arterial disease. Atherosclerosis is caused by damage to the walls of blood vessels, which causes fat to accumulate in the tissue, obstructing blood flow due to the narrowing of the blood vessels' diameters.

Other causes of peripheral arterial disease include blood vessel inflammation, limb injury, radiation exposure, and abnormal muscle and connective tissue structure in the joints.

Risk Factor

Several risk factors can increase the risk of developing peripheral artery disease, including:

• Cigarette smoke contains nicotine, which is known to damage blood vessels and raise the risk of fat deposition in the lining.
• Obesity is also a risk factor for a chain reaction of chronic diseases, including diabetes, hypertension, and high blood cholesterol levels.
• Diabetes and hypertension are chronic conditions that may damage the walls of blood vessels.
• Genetics can also play a role, particularly in persons with a family history of Peripheral Artery Disease, heart disease, or stroke.
• Age can also increase a person's risk of acquiring Peripheral Artery Disease. Over 50-year-olds are more likely to develop atherosclerosis.

Symptoms

A number of people with Peripheral Artery Disease do not exhibit any notable symptoms or indicators. However, patients with this condition are likely to experience:

• Leg pain, particularly while walking.
• Pain or cramps in the muscles of the legs or arms caused by activities such as walking that resolve when the person in pain rests the legs or arms. The location of the pain depends on where the blood vessels have narrowed. Patients with peripheral artery disease most commonly experience pain in the calf. The level of pain felt can also vary. This condition can cause discomfort and pain, resulting in limb weakening. Severe painful feelings may make it difficult to walk or do certain physical activities.
• Sensation of experiencing cold in your extremities.
• The difference in skin color is whiter and glossier, particularly when compared to the other side.
• Reduced or absent hair growth in areas affected by Peripheral Artery Disease.
• Even if you rest the affected region of your body, the pain you feel with more severe Peripheral Artery Disease will persist. This might be a bothersome issue that prevents you from sleeping well.

Diagnosis

The doctor will ask questions about the condition you are experiencing. The doctor will also perform various physical examinations to validate the health issue you are suffering from. During a physical examination, the doctor will look for particular symptoms and indicators that point to a possible diagnosis of Peripheral Artery Disease, such as touching and measuring your pulse. The doctor will also use a stethoscope to listen for irregularities in the peripheral arteries. In addition, the doctor will suspect that you have a wound that heals more slowly or is longer to heal. This condition may indicate peripheral artery disease. Furthermore, the doctor will measure the blood pressure in each limb and determine whether the pressure has decreased at the site of examination.

Doctors require additional examinations to assess a diagnosis. One of these is the ankle-brachial index (ABI). ABI compares blood pressure levels in your ankles and hands. To measure blood pressure and blood flow rate, doctors can use either a standard blood pressure cuff or ultrasound. You will be asked to walk or use a treadmill, and measurements will be taken before and after walking to determine the severity of arterial restriction.

Catheter angiography is another option for confirming the diagnosis. This treatment involves placing a catheter via the artery of the thigh until it reaches the probable narrowing site. This sort of angiography can be used to identify the exact location of the restriction and treat it accordingly. After determining the location of the narrowing of the arteries, the doctor can insert and inflate a small balloon to help widen the restricted blood vessels.

A blood test is another important supporting examination. This examination is performed to identify whether cholesterol or triglyceride levels have increased, as well as to find other disorders that may be the cause of peripheral artery disease.

Management

Treatment and therapy for Peripheral Artery Disease have two main goals: to relieve symptoms such as pain so that you can continue your daily activities without interruption, and to stop the progression of fat accumulation in the inside of blood vessels, which can cause narrowing of blood flow (atherosclerosis). Atherosclerosis can increase the risk of a stroke or heart attack; thus, it must be treated to avoid further complications.

The doctor will prescribe medication to help you avoid blood clots, lower blood pressure, and cholesterol levels, as well as relieve pain and other symptoms. If you have diabetes, your doctor will also prescribe medication to keep your blood sugar levels stable and prevent damage to the walls of your blood vessels.

If blood clots are the cause of peripheral artery disease, the doctor will prescribe medication that contains substances that destroy blood clots as they form.

If necessary, your doctor will suggest a surgical procedure to treat your peripheral artery disease. Surgery is performed by cutting a bypass through restricted blood arteries to ensure that blood flow remains uninterrupted. The doctor will establish a shortcut by implanting a blood artery from another region of the body at the narrowing site.

Complications

Peripheral Artery Disease, if not treated properly, can develop into a major, life-threatening disease. Some problems include tissue death, which can lead to amputation, impotence, severe pain that interferes with activities and makes it difficult to sleep, difficult-to-heal wounds, and an increased risk of systemic infection, sometimes known as sepsis. The most serious consequences affect the arteries that carry blood to the brain and heart. When the blood veins surrounding the brain and heart get clogged, you will have cardiac arrest, stroke, and possibly death.

Prevention

Preventive actions you can take start with modifying your lifestyle to become healthier. One of these is to quit smoking. Smoking is a harmful habit that can lead to peripheral artery disease, thereby aggravating the condition and exacerbating any consequences. In addition, regular exercise can help prevent and reduce the chance of developing Peripheral Artery Disease. Consult your doctor to discover what form of exercise is best for you. Aside from that, eating a well-balanced, nutritious diet might help you avoid high cholesterol and blood sugar levels.

When to See a Doctor?

If you experience or discover specific symptoms suggestive of Peripheral Artery Disease, consult your doctor immediately. Aside from pain, some of the signs to watch out for include visible changes in skin color. If you have chronic diseases such as diabetes or hypertension, you should see a doctor and check yourself on regularly so that you can recognize your risk of developing Peripheral Artery Disease as early as possible.

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