Your body needs oxygen to survive. Oxygen is brought to your feet (and everywhere else) in your blood, which travels through your body from your heart through arteries. Arteries are like pipes that bring blood to your feet (and everywhere else). Peripheral Arterial Disease a component of Peripheral Vascular Disease (PVD or PAD) is a narrowing of blood vessels leading to decreased circulation in the lower extremity, which is similar to a pipe being partially or completely blocked. The blood vessels narrow due to plaque buildup or “hardening of arteries” causing decreased blood flow and oxygen to the lower limbs.

If blockages form they can cause changes in your feet and legs. Patients with PAD/PVD experience pain and aching in their legs, especially with activity. Common symptoms seen in patients with PAD/PVD are leg cramps increased by walking and relieved with rest, slow healing wounds, cold or cool temperature to the legs and feet, discolored nails and decreased hair growth on the feet.

Certain risk factors can increase the risk of getting PAD/PVD such as smoking, high blood pressure, high cholesterol, diabetes and greater than 60 years of age. A family history of vascular disease or stroke can also increase the risk of PVD. It is important to be aware of the common symptoms and risks as reduced blood flow increases the risk of gangrene and limb loss.

Early diagnosis and treatment is the first step to prevent life-threatening complications or limb loss. PAD/PVDis diagnosed with a history and physical exam as well as non-invasive vascular tests. Doing non-invasive vascular tests can give your physician more information about the blood flow into your legs. One such test is an arterial doppler that can be done in the office and uses sound waves to measure the blood flowing through your arteries.

Another more accurate testing procedure, called PVR and segmental pressures, is no worse than getting your blood pressure checked. These same type of blood pressure cuffs are put on your thighs, calves, ankles, feet, and sometimes your big toe.  The cuffs inflate and slowly deflate, recording the amount of blood that passes through your arteries. The entire procedure usually takes less than a half hour.

There are a variety of reasons that a doctor might order this type of testing such as:

• a wound that will not heal
• pain in your legs that limits how far you can walk
• Inability to feel your foot pulse (your heartbeat) when they check your feet

The results of these tests determine the next steps in your treatment. Sometimes you may need to be referred to another physician such as a vascular surgeon or interventional cardiologist. Sometimes they need to do a procedure similar to a plumber unclogging a pipe. Some treatment options that may be discussed with you by the vascular specialist are stenting or angioplasty to balloon up the artery to increase blood flow. Open bypass may be considered to restore blood flow in severe cases. Other times you may only need to start a new medication and sometimes nothing more needs to be done. A discussion between you and your vascular specialist regarding the best treatment for you based on your history and condition is imperative.

There are lifestyle changes that can be made to help with PAD/PVD as well. These include quitting smoking and taking steps to control high blood pressure and diabetes. Other steps that you can take are exercising daily and eating a healthy diet. Making lifestyle changes can decrease complications from PAD/PVD and slow down its progression. Early detection and treatment of PAD/PVD can enable you to live a healthier lifestyle. Your podiatrist can help detect signs and symptoms of PAD/PVD from routine foot exams, so make an appointment with your foot doctor today. If you have any further questions please do not hesitate to ask your FASMA physician.