A blood circulation problem termed peripheral vascular disease causes the blood arteries outside your heart and brain to constrict, block, or spasm (PVD). Your arteries or veins may experience this. Pain and exhaustion are characteristic symptoms of PVD, frequently in the legs and especially when exercising. Rest typically makes the ache go away.
Additionally, it could affect the blood vessels that provide your body with oxygen and blood;
- Arms
- Intestines and stomach
- Kidneys
Blood flow is reduced, and blood vessels constrict with PVD. It may be brought on by blood vessel spasms or arteriosclerosis, sometimes known as “hardening of the arteries.” Plaques accumulate in a vessel and restrict blood and oxygen flow to your organs and limbs in arteriosclerosis.
Clots may form and block the artery as the plaque grows. If left untreated, this can result in organ damage and the loss of fingers, toes, or limbs.
Only the arteries that transport blood rich in oxygen away from the heart are affected by the peripheral arterial disease (PAD). The CDC estimates that 12 and 20 percent of Americans over 60—or 8.5 million people—will have PAD. Since PAD is the most prevalent type of PVD, the two names are frequently used to refer to the same illness.
PVD is also referred to as;
- Intermittent claudication
- Arterial insufficiency in the legs
- Arteriosclerosis obliterans
Types of PVD:
Functional and organic PVD are the two primary varieties.
There is no structural harm to your blood arteries, according to functional PVD. Your arteries instead dilate and constrict in response to external variables like brain messages and temperature variations. Blood flow is reduced as a result of constriction.
Changes in blood vessel structure, such as inflammation, plaques, and tissue damage, are a part of organic PVD.
Causes of PVD:
- Causes of functional PVD:
Your blood vessels will naturally expand and contract in reaction to your surroundings. However, in functional PVD, your vessels overreact. Raynaud’s disease, which develops when stress and temperature change your blood flow, illustrates an available PVD.
Functional PVD is most frequently brought on by;
- Emotional stress
- Using vibrant equipment
- Cold temperature
- Medicines
Your blood vessels’ structure has changed as a result of organic PVD. For instance, your blood arteries may become more constricted due to plaque development from arteriosclerosis. Organic PVD’s main contributing factors are;
Extreme trauma, abnormally shaped muscles or ligaments, blood vessel inflammation, and infection are additional reasons for organic PVD.
Symptoms of PVD:
Many patients have gradual and erratic onset of PVD’s initial symptoms. You can feel tired and crampy in your legs and feet due to a lack of blood flow, which could worsen with exercise.
Symptoms include;
- Skin changes, such as a drop in skin temperature or thinning, fragile or glossy skin on the legs or feet
- weakened pulses in the feet and legs
- Gangrene (due to a lack of blood, there is dead tissue)
- Loss of hair on the legs
- Impotence
- Heels or ankles are examples of pressure sites where wounds won’t heal
- Muscle numbness, weakness, or heaviness
- During rest, most frequently in the toes and at night when sleeping flat, there is pain (reported as burning or hurting)
- Paleness when standing with legs raised
- Discoloration of the extremities that are reddish-blue
- Impeded movement
- Severe discomfort if the artery is obstructed or extremely thin
- Opaque, thick toenails
If you experience any PVD symptoms, tell your doctor. The effects of aging are frequently dismissed as the source of these symptoms, but delaying diagnosis and treatment can lead to additional problems. During severe blood loss, dead tissue, or gangrene, can develop. A pale, aching, cold limb with weak or absent pulses is an emergency that requires medical attention. To prevent severe complications and amputation, you must receive treatment as soon as possible.
Claudication:
Claudication is the most typical sign of PVD and PAD. Walking causes lower limb muscular claudication. When you walk quickly or far, the pain can become more noticeable. Usually, it goes gone after a nap. The discomfort can take the same amount of time to go away when it returns.
Claudication happens when insufficient blood flow to the muscles you are utilizing. Only a tiny amount of blood can be supplied by the PVD’s constricted veins. When engaged in activities, this generates more significant issues than at rest.
As your PAD worsens, your symptoms will become more severe and frequent. At some point, you can even feel tired and in pain when you’re sleeping. Consult your physician for information on procedures that might enhance blood flow and lessen pain.
Risk factors of PVD:
Many things might cause PVD.
PVD is more likely to affect you if you;
Your chance of having PVD may be increased by your lifestyle decisions, which include;
- Not doing any physical activity
- Bad eating practices
- Drug use
- Smoking
Complications of PVD:
Undiagnosed and untreated PVD complications can be severe and even fatal. PVD-related restricted blood flow may be a symptom of other vascular diseases.
PVD complications may include;
- Tissue death, which can result in impotence and limb amputation
- A pale complexion
- Intense pain that limits movement
- Unhealed wounds
- Life-threatening infections of the bones and bloodstream
The most severe problems are found in the arteries that carry blood to the heart and brain. These can block up and cause a heart attack, stroke, or even death.
Diagnosis of PVD:
Early diagnosis is key to effective treatment since it can avert potentially fatal consequences.
Tell your doctor if you have any typical PVD symptoms, such as claudication. In addition, your doctor will do a physical examination and inquire about your medical history. The physical examination may involve checking your legs and feet for pulses. Your doctor may hear a whooshing sound through their stethoscope that indicates a constricted blood vessel. Tests include;
Doppler ultrasonography uses sound waves to create an image of your blood vessel’s blood flow.
Blood pressure readings from your leg and arm should be compared before and after activity using the ankle-brachial index (ABI) ultrasonography and blood pressure cuff around your ankle and arm, as decreased pressure in your leg could signify a blockage.
During angiography, a catheter directed through the artery is infused with dye. The use of paint is to identify the obstructed artery through the flow of blood vessels.
Magnetic field imaging (MRI) of blood arteries is used in magnetic resonance angiography (MRA) to identify blockages.
In computed tomography angiography (CTA), the image of a blood artery is taken with X-ray technology to identify the obstruction.
- Exercise test on a treadmill:
You will use a treadmill for this test so that your doctor can observe how your blood circulates while you exercise.
- PPG (photoplethysmography):
A tiny blood pressure cuff wrapped around the toe and a PPG sensor—which utilizes infrared light to assess blood flow close to the skin’s surface—are used in this examination, similar to the brachial-ankle index. The systolic blood pressure in the arm can then be compared between these measurements by your doctor.
This test is used for individuals unable to walk on a treadmill and is comparable to an ABI or treadmill test. Your doctor compares the blood pressure readings at your ankles and thighs when you are on your back to see whether there is any difference.
When to see a doctor:
Consult your doctor to assess if you experience peripheral vascular disease in your leg, foot, arm, or hand. Peripheral vascular disease is typically not life-threatening.
- If necessary, a medical review of your symptoms and proper therapy could help keep your heart and blood vessels from suffering additional harm.
- It might stop more severe occurrences like heart attacks, strokes, or losing one’s feet and toes.
Consult a doctor or make an appointment as soon as you can if you have any of the following symptoms;
- Chest, upper back, neck, jaw, or shoulder discomfort
- Loss of awareness or fainting
- Abrupt numbness, weakness, or paralysis of the face, arm, or leg, especially on one side of the body
- Unexpected difficulty speaking, hearing, or understanding. An unexpected problem with one or both eyes’ vision
- Sudden dizziness, trouble moving, lack of coordination or balance
- Intense headache that appears out of the blue
Keep away from trying to “wait it out” at home. Never attempt to drive by yourself.
Treatment of PVD:
Stopping the progression of the illness and assisting you in managing your pain and symptoms so you may continue to be active are the two primary objectives of PVD treatment. The therapies will also make you less likely to experience severe side effects.
Most first-line treatments include modifying one’s lifestyle. Your doctor will advise beginning a regular fitness regimen that consists of walking, decreasing weight, and maintaining a healthy diet.
You should stop smoking if you do. Smoking directly lowers blood flow via arteries. Additionally, it worsens PVD and raises your heart attack and stroke risk.
You could require medicine if changing your way of life alone is insufficient. PVD medications include;
- Pentoxifylline or cilostazol may improve blood flow and lessen claudication symptoms
- daily aspirin or clopidogrel to reduce blood clotting
- To lower high cholesterol, use atorvastatin, simvastatin, or other statins.
- When you have diabetes, you may need to take angiotensin-converting enzyme (ACE) inhibitors to lower your blood pressure and blood sugar.
Vascular surgery or angioplasty may be necessary for severe arterial blockages. A catheter or long tube is inserted into your artery by your doctor during an angioplasty. The catheter’s tip has a balloon inflated to widen the artery. Your doctor may occasionally install a thin wire tube called a stent to keep the artery open. Angioplasty procedures come in a variety of forms, including;
- In inflatable angioplasty, a little balloon is inflated inside the occluded artery to unblock the blocked regions.
- Atherectomy (a little tool on the end of a catheter “shaves” away the blocked spot inside the artery)
- A laser angioplasty (The arterial obstruction is “vaporized” with a laser)
- Stent (The blocked region of the artery is opened by expanding a small coil, which is then left in place to maintain the artery open)
Through vein grafting, vascular surgery enables blood to pass through the constrictive area.
Prevention of PVD:
Your risk of PVD can be lowered by leading a healthy lifestyle. It comprises;
- Avoid smoking
- Regulating your blood sugar
- If you have diabetes, set a target for 30 minutes of activity five times a week.
- Reduce your blood pressure and cholesterol
- Consume a diet that is balanced and low in saturated fat.
- Maintain a healthy weight
If you suffer PVD symptoms, consult a doctor. With an early diagnosis, you and your doctor can jointly come up with methods for reducing your symptoms and enhancing the effectiveness of your care.
References:
https://www.healthline.com/health/peripheral-vascular-disease
https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-vascular-disease
https://my.clevelandclinic.org/health/diseases/17357-peripheral-artery-disease-pad
https://www.medicalnewstoday.com/articles/322182
https://www.webmd.com/heart-disease/peripheral-vascular-disease
