Peripheral Vascular Disease: Symptoms, Causes, and Treatment
Peripheral vascular disease is a blood circulation disorder caused when the blood vessels present outside the heart and brain develop block, narrow, or spasm. It can happen to your veins or arteries leading to fatigue, pain, especially during exercise. With rest, the pain can improve. However, this condition also affects the vessels supplying oxygen and blood to your kidneys, stomach, intestines, and limbs.
In this condition, the blood vessels get narrow and the blood flow decreases. This can be because of a condition called arteriosclerosis in which the arteries can get hardened. Another cause of peripheral vascular disease can be blood vessel spasms. If left untreated, this condition can lead to loss of toes, fingers, or limbs and organ damage. Peripheral vascular disease is also known as arterial insufficiency of the legs, arteriosclerosis obliterans, intermittent claudication, and claudication.
Many people who have Peripheral vascular disease have little to no symptoms. Some of them experience claudication where they have leg pain while walking. Symptoms of claudication include cramping or muscle pain in your arms or legs that is triggered by an activity like walking. However, this pain disappears after resting for a few minutes. Also, the location of the pain will depend on the location of your narrowed or clogged artery. The most common symptom is calf pain. The severity of claudication also varies widely from debilitating pain to mild discomfort. In case of severe claudication, it might be hard for you to do any type of physical activity like walking.
Here are some more symptoms of Peripheral vascular disease:
- Painful cramping in either one or both of your thighs, calf muscles, or hips after performing certain activities like climbing stairs or walking
- Weakness or numbness in the legs
- Coldness in the foot or lower leg, especially when compared to the other side
- Change in the colour of the legs
- Sores on your legs, feet, or toes that won’t heal
- Slower hair growth or hair loss on your legs and feet
- Shiny skin on the legs
- Erectile dysfunction
- A weak pulse or no pulse in your feet or legs
- Pain while using your arms like cramping and aching when writing, knitting, or doing other such tasks
If the Peripheral vascular disease progresses, you might start to feel pain even when you are lying down or resting. The pain can be so intense that it disrupts your sleep. You can try walking around the room or hanging your legs over your bed’s edge to temporarily relieve yourself of the pain.
One of the main causes of Peripheral vascular disease is atherosclerosis. In this condition, the fat deposits build up on the artery walls and decrease blood flow. Even though it is mainly associated with the heart, atherosclerosis can and does affect arteries or other blood vessels throughout the body. When it occurs in the arteries that supply blood to the limbs, it is known as peripheral vascular disease.
Other causes of Peripheral vascular disease can be injury to the limbs, blood vessel inflammation, radiation exposure, unusual anatomy of the muscles or ligaments, etc.
There are certain factors that put you at more risk of developing Peripheral vascular disease:
- High cholesterol
- High blood pressure
- Increasing age
- Family of Peripheral vascular disease, stroke, or heart disease
- High homocysteine levels (homocysteine is an amino acid that helps in making protein and building and maintaining tissue)
The main goals of Peripheral vascular disease treatment are stopping it from progressing and helping you manage the symptoms and pain so that you can be active. It will also lower the risk of having serious complications because of the disease.
The first line of treatment involves making lifestyle changes. Your doctor will provide you a regular exercise program which will include walking, losing weight, and eating a balanced diet. If you smoke, you have to quit immediately as smoking can decrease the blood flow in your vessels. It can also make your Peripheral vascular disease worse and increase the risk of stroke and heart attack.
In case lifestyle changes aren’t enough, you might need some medications which can include the following:
- Pentoxifylline or cilostazol to relieve the symptoms of claudication and increase blood flow
- Daily aspirin or clopidogrel to reduce blood clotting
- Diabetes medication, if you have diabetes, for controlling blood sugar
- Angiotensin-converting enzyme (ACE) inhibitors for lowering high blood pressure
- Statins like simvastatin or atorvastatin for lowering high cholesterol
In some cases, you might need angioplasty or surgery for treating Peripheral vascular disease:
- Angioplasty - This procedure involves threading a catheter through a blood vessel to reach the affected artery. Then, a small balloon present on the top of the catheter is inflated to flattering the plaque into your artery wall. This reopens the artery and stretches it open to increase the flow of blood. Your doctor might insert a stent (mesh tube) into the artery so that it remains open. The same procedure is also used by doctors for opening heart arteries.
- Thrombolytic therapy - If your vessels are blocked because of a blood clot, your doctor might perform Thrombolytic therapy. In this, a clot-dissolving drug is injected into the blood vessels at the site of the clot so that it can break up.
- Bypass surgery - In this procedure, the doctor creates a path around the blocked blood vessel using either a synthetic vessel or a blood vessel from another body part. Through this, the blood is able to bypass the narrowed or blocked artery. In vascular surgery, the blood bypasses the narrowed artery through vein grafting.
If Peripheral vascular disease is diagnosed early, you will be able to respond to lifestyle modifications. If you want to measure improvement, you can measure the distance you are able to walk without feeling any pain. Once you get an effective treatment, you will be able to increase the distance gradually. However, if your symptoms get any worse, you should contact a doctor immediately. Some signs to look out for include your legs becoming cold, pale, blue, red, hot, or swollen, chest pain accompanied with leg pain, new ulcers or sores development that doesn’t heal, weakness, chills, fever, or any other sign of infection. By identifying these signs early, you will be able to better manage your condition.