Peripheral Vascular Disease
What is Peripheral Vascular Disease?
Peripheral vascular disease (PVD), also called peripheral arterial disease (PAD), is a slowly progressing disorder of the blood vessels, which is caused by narrowing, blockage, or spasms in the blood vessel. PVD can affect any blood vessel outside of the heart including arteries, veins, or lymphatic vessels. Organs supplied by these vessels may not get enough blood flow to function properly. The legs and feet are most often affected.
What are the Symptoms of PVD?
- About half of those diagnosed with PVD have no symptoms
- Most common first symptom is painful leg cramping that occurs with exercise and improves with rest (intermittent claudication)
- Muscle pain or cramping in the arms or legs, often in the calf
- Leg numbness or weakness
- Painful cramping in one or both hips, thighs, or claves after walking or other activities
- Pain when using the arms
- Changes in the skin (decreased temperature; think, brittle or shiny skin on the legs and feet)
- Weak pulses in the legs or feet
- Gangrene
- Hair loss on legs
- Impotence
- Wounds that won’t heal over pressure points
- Numbness, weakness or heaviness in the muscles
- Pain (burning or aching) at rest, commonly in the toes and at night while lying flat
- Paleness in elevated legs
- Restricted mobility
- Reddish-blue discoloration in extremities
- Severe pain when the artery is very narrow or blocked
What Causes PVD?
- Atherosclerosis (buildup of plaque inside the artery wall, which reduced blood flow to the limbs, possible development of clots) – most common cause
- Injury to the arms of legs
- Irregular anatomy of muscles or ligaments
- Infection
What are Complications of PVD?
- Untreated can progress to critical limb ischemia which can result in the loss of an affected limb
- Poor wound healing
- Restricted mobility due to pain or discomfort
- Severe pain in affected extremity
- Stroke (3 times greater chance in people with PVD)
How is PVD Diagnosed?
- Angiogram (x-ray of the arteries)
- Ankle-brachial index (comparison of the blood pressure in the ankle with that in the arm)
- Doppler ultrasound flow studies
- Magnetic resonance angiography (MRA)
- Treadmill exercise test
- Photoplethysmography (PPG) (similar to brachial index test)
- Pulse volume recording waveform analysis
- Reactive hyperemia test (comparative blood pressure measurements on the thighs or ankles)
How is PVD Treated?
- Lifestyle changes (exercise, nutrition, not smoking)
- Aggressive treatment of other conditions that may worsen PVD (diabetes, high blood pressure, high cholesterol)
- Medicines to improve blood flow (blood thinners, medication to relax blood vessel walls, statins to control cholesterol)
- Vascular surgery (bypass graft using a blood vessel from another part of the body or synthetic tube is placed in the area of the blocked or narrowed artery; reroutes the blood flow)
- Angioplasty (multiple options):
- Balloon angioplasty (balloon inflated inside the block artery)
- Atherectomy (blocked area is shaved away)
- Laser angioplasty (laser vaporizes the blockage)
- Stent (coil is expanded in the blocked artery)
If you have been diagnosed with peripheral vascular disease and are worried that it may be impeding your ability to continue to safely practice on patients, you should speak with an experienced disability insurance attorney.
These posts are for informative purposes only and should not be used as a substitute for consultation with and diagnosis by a medical professional. If you are experiencing any of the symptoms described above and have yet to consult with a doctor, do not use this resource to self-diagnose. Please contact your doctor immediately and schedule an appointment to be evaluated for your symptoms.
Sources:
Johns Hopkins
Yale Medicine
Mayo Clinic
