John Gribar, MD, Cardiologist
West Michigan Heart-Holland
904 South Washington, Suite 120, Holland, MI 49423
What is Peripheral Vascular Disease?
Peripheral arterial disease consists of diseases or ailments of the circulatory system. Most commonly this reflects peripheral arterial disease, or PAD. The most common presentation of PAD results from atherosclerosis. Atherosclerosis is a process by which fat or cholesterol deposit in the blood vessel wall and often causes a narrowing or blockages. As these narrowings progress, blood flow to the tissues/muscles/organs can become limited. PAD affects 10-20% over 65 years of age. African Americans are at twice the risk compared to Caucasians.
Is peripheral artery disease dangerous?
Yes. In PAD, fatty deposits build up in the inner lining of artery walls. These blockages restrict blood flow, mainly in arteries leading to the kidneys, stomach, arms, legs and feet. Left untreated, PAD can lead to gangrene and amputation of limbs. Most patients with PAD have a
higher risk of death from stroke and heart attack.
What are the typical symptoms?
Approximately 20-50% are asymptomatic. Typical symptoms are leg cramping with activity or exercise and is referred to as claudication. The most common area involved is the calf. Other locations of discomfort can include the thigh, hip or buttocks or foot. Symptoms may also include leg aches and leg fatigue. Findings can include changes in skin temperature, skin color or ulcerations of the extremities. Much less commonly, similar symptoms can also occur in the upper extremities.
Who is at risk for development of PAD? The risk factors are generally the same as they are for heart disease and stroke. Smoking is the #1 risk factor, increasing the risk 2-25X fold. Other risk factors included high cholesterol, diabetes mellitus (particularly for small blood vessels) and family history.
How is it diagnosed?
The first step in the diagnosis is gathering a detailed history of the symptoms. Additional testing based on the history and severity of symptoms can include simple blood pressure assessments in the legs, assessments of blood flow using ultrasound, noninvasive imaging of the blood vessels with CT or MRI/MRA or with an angiogram, which is a minimally invasive procedure which can be performed at Holland Hospital.
How is it treated?
The first goal of treatment is to aggressively treat the risk factors that contributed to development of PAD. Patients with PAD have high mortaility rates of secondary to concomitant heart and cerebrovascular disease. The use of medications to target CV risk factors improves survival for PAD patients.
The second goal of treatment targets the discomfort and debility that has occurred to the symptoms of PAD. This may include medicines, catheter based procedures which are offered at Holland Hospital or surgical options.
To learn more, speak with your primary care provider or a cardiologist. You may also visit www.hollandhospital.org for more information.