05 Feb The Signs of Arterial Disease (Symptoms, Causes, and Treatments)
What is Arterial Disease?
Arterial Disease or as its more commonly known, Peripheral vascular disease (PVD) refers to diseases of the blood vessels. These blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of arterial disease, doctors use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD). This is a condition that develops when the arteries that supply blood become completely or partially blocked. This is a result of atherosclerosis.
Are atherosclerosis and peripheral vascular disease related?
Atherosclerosis is a gradual process whereby hard cholesterol substances (plaques) are deposited in the walls of the arteries. This buildup of cholesterol plaques causes hardening of the artery walls and narrowing of the inner channel (lumen) of the artery. When this happens in the peripheral circulation, peripheral vascular disease is the result. The atherosclerosis process begins early in life (as early as teens in some people). When atherosclerosis is mild, the arteries are not narrowed. Atherosclerosis causes no symptoms. Therefore, many adults are unaware that their arteries are gradually accumulating cholesterol plaques. However, when atherosclerosis becomes advanced with aging, it can cause critical narrowing of the arteries. This results in tissue ischemia (lack of blood and oxygen). Atherosclerosis is often generalized, meaning it affects arteries throughout the body. Therefore, patients with heart attacks are more likely to develop strokes and peripheral vascular disease.
What are the signs and symptoms of Arterial Disease?
Approximately half of people with arterial disease do not experience any symptoms. For patients with symptoms, the most common symptoms are rest pain.
- Intermittent claudication refers to arm or leg pain or cramping in the arms or legs that occurs with exercise and goes away with rest. The severity and location of the pain of intermittent claudication vary. This depends upon the location and extent of blockage of the involved artery. The most common location of intermittent claudication is the calf muscle of the leg. Claudication leads to calf or leg pain while walking. The pain in the calf muscle occurs only during exercise such as walking. The pain steadily increases with continued walking until the patient has to stop due to intolerable pain. Then the pain quickly subsides during rest. Intermittent claudication can affect one or both legs.
- Rest pain in the legs occurs when the artery occlusion is so critical that there is not enough blood and oxygen supply to the legs even at rest and represents a more serious form of the condition. The pain typically affects the feet, is usually severe, and occurs at night when the patient is lying down, face up.
Other symptoms and signs of peripheral artery disease include:
- Numbness of the legs or feet
- Weakness and atrophy (diminished size and strength) of the calf muscle
- A feeling of coldness in the legs or feet
- Changes in color of the feet; feet turn pale when they are elevated, and turn dusky red in dependent position
Who is at risk for peripheral artery disease (PVD)?
Arterial Disease or Peripheral Arterial Disease affects approximately 10 million adults in the United States. A bout 5% of people over the age of 50 suffer from peripheral artery disease. Peripheral artery disease is slightly more common in men than in women. Most often the disease occurs in older persons (over the age of 50). The known risk factors for peripheral artery disease are those that predispose to the development of atherosclerosis. Risk factors for peripheral artery disease include:
- High blood levels of the “bad” LDL cholesterol and triglycerides
- Low blood levels of the “good” HDL cholesterol
- Type 1 and Type 2 Diabetes
- High blood pressure (hypertension) or a family history of hypertension
- A family history of atherosclerotic disease
- Chronic renal failure
- Overweight or obesity
- Physical inactivity
How does atherosclerosis cause disease?
Atherosclerosis causes disease in two ways.
1) Atherosclerosis can limit the ability of the narrowed arteries to increase delivery of blood and oxygen to the to tissues of the body during times when oxygen demand needs to be increased, for example, during exertion.
2) Complete obstruction of an artery by a thrombus or embolus (thrombus and embolus are forms of blood clots), which results in tissue death (necrosis). Exertional angina and intermittent claudication are two examples of insufficient delivery of blood and oxygen to meet tissue demand; whereas strokes and heart attacks are examples of death of tissue caused by complete artery obstruction by blood clots.
There are similarities between coronary artery diseases (atherosclerosis involving the arteries of the heart) and arterial disease, and the two conditions may coexist in the same individual.
For example, patients with exertional angina typically have no symptoms at rest. However, during exertion the critically narrowed coronary arteries are incapable of increasing blood and oxygen delivery to meet the increased oxygen needs of the heart muscles. Lack of blood and oxygen causes chest pain (exertional angina). Exertional angina typically subsides when the patient rests. In patients with intermittent claudication, the narrowed arteries in the lower extremities (for example, a narrowed artery at the groin) cannot increase blood and oxygen delivery to the calf muscles during walking. These patients experience pain in the calf muscles that will only subside after resting.
What are the other causes of peripheral vascular diseases (PVD)?
A number of conditions such as vasculitis may cause damage to blood vessels throughout the body. Injuries to blood vessels; from accidents such as auto accidents or sports injuries, blood-clotting disorders, and damage to blood vessels during surgery can also lead to inadequate blood supply to body tissues.
Tissue ischemia can also occur in the absence of atherosclerosis or other abnormalities of arteries. One example of a condition in which the blood vessels themselves are not damaged is Raynaud’s disease, which is believed to occur due to spasms in blood vessels brought on by stress or a cold environment.
Since atherosclerosis of the peripheral arteries (PAD) is by far the most common cause of peripheral vascular disease, the rest of this article focuses upon peripheral artery disease.
If found early enough, PAD may be possible for a patient to treat it with lifestyle changes. This most often entails quitting smoking, undertaking an exercise program, and focusing on a healthy diet. It is important to note that if you believe you may be suffering from PAD, you must see a doctor. This is potentially a limb and life-threatening condition. Your doctor will determine the best course of treatment for you. If you are suffering from Arterial Disease in Friendswood, Texas City, League City, Angelton, Galveston County, Pearland, or the surrounding Greater Houston Area, Coastal Vascular can help.