Peripheral Artery Diseases - Risk, Symptoms, Diagnosis and Treatment

Peripheral Artery Diseases or peripheral arterial diseases occur as a result of the narrowed arteries. Arteries are the vessels that carry oxygen from the heart to the whole body.  

In the condition of Peripheral artery diseases, the arteries get narrowed, reducing the blood flow. Thus, reducing blood flow to tissues and organs within the affected area.   

Peripheral artery diseases can occur in any part of the body, but the condition is more common in the legs and arms. Peripheral artery disease and Peripheral vascular disease (PVD) share similarities.  

The prime difference is that PAD is a specified disease condition, where primarily the arteries of the arm and legs get affected. PVD impacts the arteries, veins and lymph nodes. The disease can affect any part of the body, including the neck and face.  

Risk factors of PAD  

The principal cause of Peripheral artery disease is the build of fatty plaque in the arteries. Atherosclerosis is the common term used to refer to fatty deposits. Fat deposits form as a gradual process over time; they become a mass substance and narrow the arteries.  

The secondary risk factors may include,

• Blood vessel inflammation  
• Injury in limbs  
• Smoking 
• Diabetes  
• High cholesterol  
• High blood pressure  
• Blood clots in arteries  
• Age (more common in people of age between 50-65)  

Peripheral artery disease occurs in both men and women. Among the listed factors, Diabetes and smoking develop a high risk of Peripheral artery diseases.   

Early and advanced symptoms of PAD  

Symptoms are the only way to diagnose the disease and alarm the individual about the medical need. In that case, most people with Peripheral artery diseases are not aware of the condition because it leaves no symptoms.  

Apart from the crucial symptoms, the early symptoms include the severity of pain and discomfort in the affected area.  

The pain gradually grows from mild to severe along with any physical activity (such as walking, running, playing, etc.) and gets relaxed after a nap or rest. Then, the pain tags along when the physical activity gets resumed.  

• Numbness  
• Weakness  
• Tired  

These are some symptoms that are accompanied by pain in the affected area. The reduced blood flow in the body causes pain.  

The following are the advanced symptoms of Peripheral artery diseases.  

• Slow growth in toenails  
• Change in skin colour  
• Hair loss or slow hair growth  
• Sore on the skin  
• Cold skin  
• Frequent infection  

The symptoms are visible in the affected area of the skin. During the initial stages, the pain occurs only during the time of physical activity. In the progressive stage, the pain will never leave the side.  

PAD in arms  

The fatty plaque build-up in the arteries of the arms leads to PAD in the arms. PAD occurs because of health conditions like an autoimmune disorder, atherosclerosis, embolism, etc. PAD in the arm follows the symptoms below.  

• Severe hand pain  
• Arm cramping  
• Non-healing sores  
• Slow nail growth  
• Cold skin  

Arm affected with PAD usually feels heavy during arm activities. When the blood flow reduces, the tissue and cellular growth get affected, and the healing capacity becomes slow or weak. Fatigue, heavy arm and sensitivity to cold are the other consequences seen in people with PAD.  

How does smoking affect PAD?  

Smoking is hazardous to overall health. The toxin of smoking causes inflammation and redness, which contributes to the plaque deposit in the artery walls.  

The toxin chemicals inhaled during smoking affect the blood cells and slowly kill the function of the heart and other organs.  

How is PAD diagnosed?  

If PAD symptoms exist, then consult a doctor. There are various ways to diagnose PAD.  

However, the diagnosis process starts with a discussion of family medical history and other health complications like Diabetes, etc. Then follows the physical examination. The further diagnosis steps include the following.  

The ankle-brachial index (ABI) is the most frequently used test to diagnose PAD. This test checks the blood pressure in the arms and ankle. ABI is a painless test.  

A blood pressure cuff with an ultrasound device checks for the blood pressure in both arms and legs. If the result appears to be different from the other, then PAD is confirmed.  

Segmental Doppler pressure test is similar to ABI tests. The ultrasound device connected to it amplifies blood flow in the arteries. The results of the test can detect blockages in the arteries.  

An ultrasound test analyses blood circulation using ultrasound techniques. The test helps to rule out the affected or blocked area or location and also checks the blood flow rate in the arteries. In addition, the ultrasound test is also helpful in tracing the success rate of PAD treatment.  

A blood test to check for other diseases and abnormalities such as high blood sugar level, cholesterol level, triglyceride, Diabetes, etc.  

An imagery test like a CT scan gives a clear picture of arteries. Moreover, with the injection of a special dye, an X-ray can locate the blocked arteries.  

Angiography tests use a special dye that is injected into the body to test the blood flow through the arteries.  

A catheter angiography test helps to find the exact location and severity of the blockage. A small tube (catheter) is inserted into the artery and guided further into the affected area to locate the affected area.  

A special dye is released through the catheter during the process, and then X-rays are passed to get the exact location of the blocked blood vessels. Catheter angiography provides the accurate location of the affected blood vessels.   

Treatment options for PAD  

No treatment is available to cure PAD permanently. The treatment options aim to  

• Reduce the symptoms of PAD  
• Relieve the pain  
• Prevents the other major complications of PAD (such as chronic heart disease, heart attack, etc.)  
• Improves the ability to perform physical activities  

However, suitable treatment options will be suggested by the doctor. Quality of life is possible with medications, surgery and lifestyle changes.  

Medications are prescribed to reduce the symptoms and prevent complications. If the disease gets complicated even after treatment, then considering the severity of the PAD, surgery options will be defined.  

The surgery options include the following.  

Angioplasty surgery helps to clear up the fatty deposit blocking up the artery walls. In this procedure, a small deflated balloon is attached to the catheter, which is processed into the artery.  

The balloon is inflated through the catheter to clear the fatty plaque. At times the balloon is coated with medicine that helps the artery heal. Sometimes a mesh tube (stent placement) is inserted with the balloon to help the artery to keep it open. This mesh is inserted to reduce the risk of narrowing the artery again.  

Bypass surgery is suggested during the severe condition of PAD or where there is no possibility that angioplasty will work for better results. This surgery aims to create a path around the blocked artery, either using the blood vessel from another part of the body or an artificial (synthetic) vessel.  

As the result of the surgery, a bypass path is created for the blood vessels to flow around the blocked area of the artery.  

Atherectomy - a surgical procedure that involves a catheter with a blade at the end to remove the fatty plaque deposit in the arteries.  

What is the complication of PAD?  

If untreated Peripheral artery diseases can turn into a life-threatening condition. The below list reveals the health complication followed by PAD.  

• Heart attack  
• Stroke  
• Transient ischemic attack (TIA - a temporary interruption in the blood vessels)  
• Renal artery diseases or stenosis (block in arteries that supply blood to the kidney)  
• Critical limb ischemia (an injury or sores that do not heal)  

Apart from the above complications, Coronary artery disease is stated as one of the complications of PAD. Even though both have differences, the diseases are interconnected. People with PAD are likely to develop Coronary artery disease or vice versa.  

Coronary artery disease occurs when the fatty plaque build-up happens in the arteries that carry blood to the heart. The plaque is made up of cholesterol deposits. This results in different heart-related problems and complications.  

Living with PAD  

First, it is vital to know the function of the body. Although PAD is severe and painful, an active life is possible by following regular exercise and a healthy diet along with medications.  

Exercise for PAD   

Walking serves as the best exercise for PAD. The root cause of the disease is circulatory problems and fat deposits; fortunately, walking benefits both conditions. Walking regulates the correct blood flow and reduces the fat deposit. Thus, walking can bring a great change for people with PAD.   

Start with getting the right shoes to support the legs.  

Before starting the baby steps, practice following the correct stretching exercise to avoid muscle injury, cramps, pain and other complications.  

Slow and steady wins the race, so start it slow. Stop for rest. Do not push the limits.  

Follow and achieve the goals regularly.   

If the need arises to switch from walking, then consider gentle yoga. Because yoga also helps to regulate blood flow. Consider consulting a doctor before practising exercise and yoga to be cautious about the following health complications.   

Food for PAD  

Apart from the diet and food for PAD, healthy eating is essential for a healthy lifestyle. High cholesterol and fat in the blood lead to the risk of PAD. So, foods high in cholesterol can increase the risk of PAD.   

Try to reduce the bad fat. Increase intake of good fats like monounsaturated, polyunsaturated and omega-3 fatty acids. Good fats will not increase the blood cholesterol level. Foods that contain good fats include olives, soybeans, peanuts, nuts, seeds, avocados and fatty fish such as salmon, trout, etc.

The next is fibre; there are two types of fibre, soluble and insoluble. Both are important for good health. Soluble fibre reduces the risk of PAD and heart diseases as it minimises unhealthy cholesterol. The foods rich in soluble fibre are dried beans, peas, lentils, whole grains such as oats and barley and vegetables.  

When the topic changes to a diet for PAD, then the Mediterranean diet suits the needs because the diet focuses on the intake of healthy fat and decreases unhealthy fat.  

Prevention of PAD  

PAD is not curable, so it is better to take cautious measures. The prevention measures include the following:  

• Quit smoking  
• Healthy diet  
• Healthy weight  
• Follow regular exercise  
• Treating blood sugar level    
• Practice regular exercise and a healthy diet to lead a well-being life.

Before practising any kind of diet and exercise, consider consulting a doctor.  

Conclusion  

Prevention falls into the hands of individual responsibility. A healthy diet along with regular exercise is all enough to resist the maximum of diseases. PAD is a lifelong condition; the treatments will aim to reduce the symptoms and prevent it from getting complicated.  

PAD leads to many health complications like heat stroke, so treating the disease at its early stages is vital. Severe stages of PAD are treated with surgery, but the mild stages can be improved by following a healthy lifestyle.  

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