Jessamine County Coroner

Peripheral Arterial Disease

Many Americans suffer with discomfort and pain in their legs, most often while walking, jogging or during some other type of physical activity.  Although such symptoms, especially if only occasional or temporary, don’t necessarily mean that you have this disease, it may be a good idea to talk to your medical provider if they occur frequently or become severe.  Peripheral arterial disease (PAD) occurs when the walls of the arteries begin to accumulate deposits of fat and cholesterol.  The vessels become hardened and cannot widen when more blood is needed in the legs such as during walking, especially uphill.  The classic symptoms usually affect men over 50, and include pain, achiness, fatigue, burning or discomfort in the muscles of the feet, calves or thighs.  Generally, the symptoms appear mostly when walking fast, uphill or for long distances.  They usually go away after several minutes of rest.  Slowly, the symptoms come on more quickly and with less exercise.  The legs may feel numb at rest, and cool to the touch.  When the disease becomes more severe, other symptoms may accompany it, such as impotence, pain and cramps, pain and tingling in the feet or toes (even the weight of bed sheets may be painful).  Sometimes the pain is worse when the leg is elevated and relieved when you dangle your legs over the side of the bed.  Eventually calf muscles may shrink and hair loss will occur over the toes and feet. Painful, non-bleeding sores or ulcers may appear on the skin (usually black) which won’t heal properly and paleness of the skin or blue color in the toes or foot (cyanosis) may ultimately occur.

Your doctor or other health care provider can order specialized testing to determine if you have PAD, such as angiography of the arteries in the legs, specialized blood pressure measurements in the ankles and arms, Doppler ultrasound exam of the legs, MRA or CTA.

You can help yourself by balancing exercise with rest.  As you exercise to the point of pain, then resting, you can actually develop new, small (collateral) blood vessels to form.  Of course talk with your doctor before starting any exercise program if you suffer the symptoms of PAD.  Stop smoking immediately, as nicotine constricts the walls of the arteries, thereby making it even more difficult for the blood to flow through them.  If you also have diabetes, the symptoms and the risks are worsened.  Take good care of your feet by wearing shoes that fit properly, and watch for sores, cuts or scrapes which may not heal properly due to the decreased blood flow.  If such injuries occur, see your doctor right away.  Do your best to maintain proper weight, blood pressure and cholesterol.

A vascular specialist can assess you and perform various surgical procedures if medication alone cannot alleviate your PAD. Contact your doctor sooner rather than later if you have these symptoms.  Early intervention generally leads to better results and outcome with this disease.

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