WITH THE GROWING AWARENESS OF HEART DISEASE and all of the medication advertisements that are on TV these days, heart disease is a popular topic of conversation. What you may not know is that this can occur in places other than the heart. It can occur anywhere in the circulatory system of the body.
Peripheral arterial disease occurs when your circulation is poor because of clogged or narrow arteries and often happens in the lower extremities. Typically, the risk factors for this process are similar to those of heart disease, such as smoking, diabetes, poor diet, lack of exercise, and high blood pressure. This disease may not show symptoms, meaning that you may not even know that there is a narrowing of the arteries. However, if the disease is severe enough, you may feel pain in the legs after physical activity, such as walking or going up the stairs, that improves with rest. In the most severe cases of the disease, you may feel pain while resting, which may only improve with dangling the legs over the side of the bed or chair.
The question is, what causes this pain? Humans need oxygen to live. Oxygen is carried in our blood through vessels called arteries, which are like pipes, from the heart to the tissues of the body. When tissues do not receive enough oxygen to carry out the tasks they need to survive, they are said to be ischemic, and this causes pain. Activities such as exercise or even just walking make your muscles and tissues need more oxygen. If the arteries of the legs are narrowed, oxygen can’t get to your tissues and muscles, and this causes them to hurt. When you rest, your muscles and tissues need less oxygen, causing the pain to lessen or even go away completely. This cycle of pain in the legs with activity that goes away with rest is referred to as claudication, and it needs an evaluation by a physician, typically a vascular surgeon. In some cases, when the tissues don’t get enough oxygen for a long time, this can cause leg and foot ulcerations and even eventual leg amputations.
Leg wounds from poor blood flow are typically found on shins, heels, tips of toes, or between the toes where the skin rubs together. These wounds can be pale, dark red, yellow, gray, or black in color, and they usually do not bleed. There may or may not be swelling around the wound, depending upon whether infection is present or not. If the leg is dangled down for a period of time, it will typically turn red. When elevated, this redness will turn pale and cool to the touch. Ischemic wounds are often very painful, and many individuals find the pain subsides when the leg is dangled downward, possibly as a result of gravity assisting blood flow and oxygen reaching the tissues.
So, what can be done to treat this? You should see your healthcare practitioner first. He or she may encourage you to stop smoking and start a walking regimen. Walking and exercise work by helping the blood flow through the arteries that are not blocked. He or she may help you follow a healthy diet and take medications for your high blood pressure or diabetes. Your healthcare practitioner may also ask you to have ultrasound examinations, CT scans, or MRIs. In some cases, another test known as an angiogram may be needed. This is where a dye and x-ray are used to locate and sometimes fix the blockage with a stent. Medications can also be used to help your arteries from reclogging. In some circumstances, the artery is diseased to the point where it requires an open surgery, such as a bypass of the narrowing.
Arterial disease is not something that just happens in the heart. It can be a slow process that can cause pain, wounds, and decreased function. Specialists such as vascular surgeons are equipped to diagnose and treat these conditions. Above all else, the best solution is always prevention. That means eating a healthy diet, exercise, and, most importantly, smoking cessation. If these principles are applied, peripheral arterial disease may be a burden you do not have to bear. ✲
