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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).
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.
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
Being overweight or obese
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
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.
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.
Atherectomy (shaving away the plaque causing the blockage)
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.