Peripheral Arterial Disease (PAD)

Peripheral Artery Disease (PAD) Q&A

What Is Peripheral Arterial Disease?

Peripheral arterial disease is the narrowing or blockage of your peripheral arteries that carry blood from the heart to the legs and sometimes the arms. It is caused by the buildup of plaque (fat and cholesterol) in the arteries, called atherosclerosis.  This makes it difficult for your blood to carry oxygen and nutrients to the tissues in your body and organs.

When the legs do not receive enough blood flow, it may cause pain when walking, accompanied by other symptoms.  Once the arteries become blocked or narrowed, it can cause damage and eventually gangrene (death) to the surrounding tissues, often occurring in the toes and feet. PAD’s rate of progression varies from person to person depending on various factors like where the plaque forms in the body and your overall body health. The same types of arteries that supply your legs also supply your heart and thus a blockage in the legs may indicate the arteries around the heart could also have significant disease.

What Are Symptoms of Peripheral Artery Disease?

Most people have mild or no symptoms, while others have leg pain when walking (intermittent claudication). Claudication symptoms include cramping, muscle pain, achiness, or tiredness that begins when walking or exercising and resolves when you rest. The pain is common in the calf, ranging from mild to severe. Other symptoms include:

• Leg numbness or weakness
• No pulse or a weak pulse in the legs or feet
• Coldness in the lower leg or foot
• Weak pulse in the feet or legs
• Shiny skin on the legs
• Poorly healing sores or wounds on the legs or feet
• Change in toenail and leg hair growth 
• Skin color changes on the legs
• Erectile dysfunction
• Pain when using the arms to perform manual tasks
• Painful cramping in calf muscles, hips, or thighs after certain activities

When PAD worsens, you may feel pain when resting or lying down, interrupting sleep. For temporary pain relief, walk or hang the legs at the edge of the bed. 

What Are the Risk Factors for PAD?

You raise your risk of PAD if you: 

• Are older than 50
• Have heart disease
• Have a history of cerebrovascular disease or stroke
• Have high blood pressure
• Are obese or overweight
• Have diabetes
• Smoking
• Have abnormal cholesterol
• Are physically inactive
• Use drugs
• Have kidney disease and/or require hemodialysis
• Have a family history of high cholesterol, high blood pressure, or PVD

PAD is a long-term disease but can be managed by changing lifestyle habits like stopping smoking and regular exercise.

How Is Peripheral Artery Disease Diagnosed?

The cardiologists at Reading Cardiology Associates will conduct a comprehensive evaluation to diagnose PAD accurately. Your cardiologist will review your symptoms and ask you questions about your medical and family history, perform a physical examination and perform diagnostic tests such as:

Ankle-Brachial Index (ABI)

This standard test is used to diagnose PAD by measuring the blood pressure in your ankle and comparing it with the blood pressure in your arm. Your cardiologist may ask you to walk on a treadmill then blood pressure readings are taken before and immediately after exercising to monitor the arteries during walking. This helps to know the severity and progression of your PAD.

Blood Tests
Blood tests check for risk factors like high cholesterol, high triglycerides, and diabetes. 

Peripheral Angiogram
A peripheral angiogram is a test that uses contrast dyes and X-rays to help your cardiologists to check for blockages in the arteries in the legs and feet.

Computed Tomographic Angiography (CT) 
A CT scan images the arteries in your legs, pelvis, and abdomen, especially for patients with stents or pacemakers.

Arterial Testing Ultrasound 
Arterial testing is a noninvasive, painless vascular ultrasound wave to assess blood flow through your limbs, identify blockages in the veins and arteries and detect blood clots.  A Doppler ultrasound (duplex) imaging measures blood flow in an artery to detect the presence of a blockage – is typically part of this exam.

Pulse Volume Recording (PVR)
PVR is a non-invasive vascular test whereby blood pressure cuffs and a handheld device measure the blood volume changes in your arms and legs. It helps your cardiologist identify blockages in the arteries in the legs and diagnose leg artery disease. 

How Is Peripheral Artery Disease Treated?

Our cardiologists at Reading Cardiology Associates customize treatment plans for PAD based on your exam results and the severity of your symptoms. Lifestyle changes can dramatically improve and relieve symptoms such as:

• Eating a healthy diet
• Quitting smoking
• Exercise regularly
• Stress management
• Control blood sugar levels
• Manage cholesterol and blood pressure levels

Other medical treatments may be recommended depending on the severity of your symptoms such as:

Medication to help lower cholesterol, anti-clotting drugs, improve poor circulation, lower cholesterol, blood pressure, and blood sugar levels.

Surgical procedures such as bypass grafting or angioplasty, stent placement, atherectomy, and thrombolytic therapy. 

For a comprehensive peripheral artery disease evaluation, call Reading Cardiology Associates or book an online appointment today.