As a board-certified vascular specialist, Kevin Treto, M.D. says one of the most common conditions he treats is peripheral arterial disease (PAD). It’s no wonder that it comes up so frequently; more than 6.5 million Americans over the age of 40 suffer from the disorder, which can be serious without proper treatment. 

Why is this illness so common? What are the symptoms of PAD, and how can you prevent it? In this blog, Dr. Treto and the team at Vascular Specialists of Central Florida provide answers to these questions.

What Is PAD?

Peripheral artery disease, or PAD, is an illness of the body’s circulatory system. The goal of this system, which is made up of your heart and blood vessels, is to provide hormones, nutrients, and oxygen to your body while removing waste. Think of your circulatory system like a network of highways. Blood pumps from the heart, traveling through this superhighway of arteries and veins. 

In the circulatory system, there are three types of blood vessels:

  1. Arteries carry oxygen-rich blood from the heart to the rest of the body
  2. Veins return the oxygen-depleted blood back to the heart for rejuvenation
  3. Capillaries connect everything together all allow the oxygen, nutrients, and waste to pass in and out of our cells

If you have PAD, your arteries have narrowed, which reduces the flow of oxygen-rich blood from the heart to your extremities. The normally efficient process of blood flow slows down considerably because the arteries at the frontend of this process become blocked, narrowed, or somehow thwarted from doing their job.

What Causes PAD?

Most of the time, PAD is caused by the buildup of fatty plaque in the arteries, a disease known as atherosclerosis. Dr. Treto says, “PAD is an accumulation of certain products in the artery that causes them to harden and ultimately cause a blockage. The result of that is you get less blood flow to the target organs, such as your legs.” 

If you’ve heard people talking about “hardening of the arteries,” they are probably discussing a condition known medically as atherosclerosis. Atherosclerosis is a condition that causes plaque to build up in the body’s arteries. Plaque is a sticky build up consisting of calcium, cholesterol, fat, and other waste products from the blood. Over time, your arteries harden and narrow, which is exactly what leads to PAD.

There are several risk factors for developing PAD, some of which are preventable, and others are not. Risk factors for PAD include:

  • A family history of heart disease, PAD, or stroke
  • Age (50+) 
  • Diabetes
  • Elevated cholesterol
  • High blood pressure
  • High levels of an amino acid called homocysteine
  • Obesity (which is defined as a BMI greater than 30)
  • Smoking

While we can’t control some of the things that cause PAD, it’s worthwhile to change whatever lifestyle issues that may cause the disease.

How Does PAD Threaten My Health?

A diagnosis of PAD is potentially serious. When blood flow is blocked, the oxygen that sustains tissue life is also thwarted. In severe cases, PAD can block the blood flow and cause tissue death that can lead to a leg or foot amputation.

PAD can cause a number of nasty complications that threaten your health, and possibly your life, such as:

  • Critical limb ischemia, which is when an extremity sore causes tissue death
  • Heart attack
  • Stroke

Given the serious complications associated with the disease, it’s important to maintain a healthy lifestyle in order to prevent PAD if you know you are at risk. This includes maintaining a healthy diet, exercise, weight loss, and quitting smoking.

What Are the Symptoms of PAD?

Dr. Treto says, “The most common symptom of peripheral arterial disease tends to be in your legs, particularly with walking.” 

He continues, “You get pain in your legs, signifying that you don’t have enough blood flow to those muscle groups.” This pain is usually triggered by exercise and centers in the calf muscle but disappears after you rest. 

Watch carefully for these signs of PAD:

  • Coldness in a foot or lower leg
  • Color changes in the skin of your legs
  • Cramping in the hip, thigh, or calf after climbing stairs or walking
  • Erectile dysfunction in men
  • Foot or leg sores that don’t heal
  • Loss of hair and shiny skin in the area where you have pain
  • Pain in your arms when doing manual tasks
  • Toenails that seem to grow slowly or not at all

Less commonly, you could develop PAD from other conditions, such as a limb injury, radiation exposure, blood vessel inflammation, or other issues. Most of the time, though, the issue is atherosclerosis, which is a treatable condition.

It also should be noted that four in 10 people have PAD with no leg pain. This illustrates why regular checkups with your doctor are so important for the prevention of serious illness. If you are over 65 years old, or are younger but have a history of smoking, diabetes, or obesity, ask your doctor about PAD.

How Is PAD Diagnosed?

Diagnosis of PAD begins with a painless physical exam. Your doctor may also conduct additional tests such as:

  • An angiography, which injects dye into your blood vessels to better visualize blood flow
  • An ankle-brachial index (ABI), which is used to compare blood pressure in your ankle with your arm
  • An ultrasound, which provides a visual image of the blood flowing through your vessels
  • Blood tests, which can also measure cholesterol and other contributors to PAD

With a positive diagnosis, your doctor can help you come up with the right treatment plan.

What Is the Treatment for PAD?

Dr. Treto says, “The treatment for peripheral arterial disease is multifactorial. There are certain lifestyle modifications one can do to reduce the symptoms. There are also medications that can improve the symptoms and treat the arteries.”

While these treatments are the least invasive way to try to improve your health, Dr. Treto says, “Ultimately, there are surgical procedures we can do to either open up the blockages or bypass them to improve the blood flow.” 

The types of surgery you may need can include:

  • Endovascular revascularization, which involves the insertion of  a catheter into the affected artery to reopen it
  • Bypass surgery, which creates a path around the blockage with a synthetic vessel or a transplanted vessel from another part of the body 
  • Thrombolytic therapy to dissolve any blood clots that are contributing to the artery blockage

PAD treatment begins with a visit to Vascular Specialists of Central Florida. Dr. Treto and his team will help you understand, diagnose, treat, and manage this condition. Call us to improve your health.

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