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A Peripheral Vascular Disease (PVD) patient walks on a treadmill while a nurse looks on

What is Peripheral Vascular Disease (PVD)?

While we often think of cardiovascular disease as impacting just the heart, the truth is that there is a vast vascular network of veins and arteries extending throughout the body, and disease affecting this network can be equally problematic for health. When the blood vessels in parts of the body beyond the heart become blocked or narrowed, blood flow can be impeded and blood clots may even develop in a condition known as peripheral vascular disease (PVD).

What Causes PVD?

By far, the most common cause of PVD is a condition known as atherosclerosis in which plaque gradually builds up within the walls of blood vessels, causing them to narrow. This is most common in the vessels furthest from the heart and is commonly seen in the lower legs. As PVD develops, the limbs are no longer receiving adequate blood flow and can develop a number of complications due to reduced circulation.

What are the Risk Factors associated with PVD?

There are specific risk factors which can increase a patient’s chances of developing PVD. These include:

  • Age (over 50)
  • History of heart disease or coronary artery disease
  • History of high cholesterol or blood pressure
  • Family history of PVD
  • Diabetes
  • Being overweight or obese
  • Smoking

What are the Symptoms of PVD?

The symptoms of PVD are not always readily obvious. In fact, it can be notoriously difficult for patients to pick up on the subtle signs that may accompany the disease. This just makes it all the more important for anyone at risk for PVD to fully understand the many ways in which the condition may present itself, including:

  • Leg pain with physical activity (claudication)
  • Weak pulse in the legs
  • Slowed hair growth or hair loss on the legs
  • Cold legs and feet
  • Changes in skin color
  • Muscles that feel numb, weak or heavy
  • Thick, opaque nails

How is PVD Diagnosed?

Once PVD is suspected, there are some very simple tests a cardiologist may perform to confirm the diagnosis. Three of the most commonly used PVD diagnostic tests are:

  • Ankle Brachial Index (ABI) – An ABI is a simple test in which blood pressure measurements taken from the leg are compared with those obtained from the arm. If a weakened blood pressure is detected in the legs, it is a good indicator that PVD may exist.
  • Doppler Ultrasound – This ultrasound test uses high-frequency sound waves to produce images of the blood vessels and to assess blood flow. Detecting less blood flow than normal during a doppler ultrasound of the extremities can point to PVD.
  • Angiogram – An Angiogram is a specific type of x-ray that also uses an injection of contrast dye to see the blood vessels and visualize any areas of narrowing or blockage.

How is PVD Treated?

The treatment method used for PVD will depend on both the patient and the severity of their condition. Most treatment plans will include one or more of the following options:

  • Lifestyle changes to improve overall health and reduce risk factors. These may include exercise, diet, and quitting smoking.
  • Controlling co-existing conditions which may contribute to and exacerbate PVD such as diabetes or high blood pressure.
  • Taking medications to enhance blood flow such as blood thinners.
  • Bypass surgery in which a synthetic material or graft from another part of the body is used reroute blood around the damaged area.
  • Angioplasty in which the surgeon uses one of the following techniques to reopen the narrowed vessel:
    • Balloon
    • Stent
    • Laser
    • Atherectomy (shaving away the plaque causing the blockage)

What are the Possible Complications of PVD?

If left untreated, PVD can lead to serious and even life and limb-threatening complications. In fact, patients with PVD are up to three times as likely as others to suffer a stroke. They also tend to experience problems such as slow or non-healing wounds, increased rates of infection, pain and restricted mobility. However, chief among the concerns for PVD patients is amputation. Over 90 percent of all amputations in America share some connection with PVD, making this complication one of the most realistic and frightening possibilities.

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