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What You Need to Know About Clogged Arteries

Friday, September 14, 2012

 

September is Vascular Disease Awareness Month. Each week, Dr. Louis Messina will be focusing on a form of vascular disease. This week, Dr. Messina, a vascular surgeon at the Division of Vascular and Endovascular Surgery at UMass Memorial Medical Center, is taking a closer look at Peripheral Arterial Disease (PAD), a condition that affects millions of Americans.

What is Peripheral Arterial Disease (PAD)?

Peripheral Arterial Disease (PAD) is when the peripheral arteries, arteries other than those in the heart, become narrowed or clogged with fatty deposits, or plaque. The buildup of plaque causes the arteries to harden and narrow, which is called atherosclerosis.

PAD is a relatively common condition affecting between 5 to 20 percent of individuals greater than 65 years of age. While the majority of individuals who have PAD have no symptoms, it increases their risk for heart attacks, stroke, and death from cardiovascular disease by four to five fold higher than those not affected by this condition.

Currently, it is considered the most under diagnosed and under treated cardiovascular disease. For example, one in three patients with diabetes will develop PAD. PAD can also affect the carotid arteries (arteries in the neck), the renal arteries (arteries to the kidneys) and the mesenteric arteries (arteries to the stomach, liver and intestines).

When leg arteries become hardened and clogged, blood flow to the legs and feet is reduced. This reduced blood flow can become apparent to in an individual so affected that they may develop two types of symptoms. One is called “claudication”. Claudication refers to pain that can occur in the legs while walking and is relieved by a few minutes of rest. The pain can occur in any muscle group and is the location is determined by the level of the blockages caused by atherosclerosis.

Claudication occurs most commonly in the calves. This condition is not limb-threatening but if it occurs after short distances, can significantly reduce the ability of the individual to walk and thereby reduce their quality of life. In the later stages, leg circulation may be so poor that a condition called Critical Limb ischemia can develop. Pain occurs in the toes and feet during periods of inactivity or rest. Untreated PAD can lead to difficulty walking, and in most severe stage, gangrene and leg amputation.

It’s worth knowing that having PAD places a patient at risk of having other serious health problems, such as heart attack and stroke. The good news is that PAD can be treated by making lifestyle changes, by taking medicines, having endovascular or surgical procedures, if needed. Considering that 80 percent of PAD cases go undetected, understanding you risk factors are critical to improving the chance of survival.

The Risks

• PAD can happen to anyone, regardless of age, but it is most common in men and women over age 50.
• PAD affects up to 20 percent of Americans age 65 and older.
• People who have PAD often have arterial blockages in other parts of the body and are, therefore at greater risk of suffering a heart attack.
• Smoking, high cholesterol and diabetes are three critical risk factors for PAD
• People with a family history of vascular disease, PAD, aneurysm, heart attack or stroke
PAD Symptoms
• The most common symptom of PAD is called claudication, which is leg pain that occurs when walking or exercising and disappears when the person stops the activity
• A lower temperature in one leg compared to the other l
• Poor nail growth and decreased hair growth on toes and legs
• Other symptoms of PAD include: a near continuous pain in the forefoot that occurs most commonly at night when lying in bed. The development of painful areas of ulceration that occur over bony prominences in the foot, and finally the development of what is called “dry gangrene” which develops when to the tissue of the forefoot dies and becomes a black scab.

If you think you may have PAD, contact your physician immediately. You can find more information about PAD on the UMass Memorial website. Also, you can find information online about PAD from the Society of Vascular Surgery and the Vascular Disease Foundation.  

 

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