Heart & Circulation Problems

Peripheral Artery Disease

Peripheral artery disease (PAD) occurs when blood vessels outside of the heart become too narrow to supply enough oxygen to the limbs. Blood flow is reduced. This is most common in the legs and much less common in the arms. Often, PAD occurs with coronary artery disease.

Signs & Symptoms

•  Muscle pain in one or both legs when walking, especially when walking fast or uphill. The pain lessens or goes away with rest. Pain can be in the calves (most often) or thighs. Much less often, it can also be in the arms, fingers, lower back, buttocks, or the foot arches.

•  Fatigue that improves with rest

With severe disease, symptoms are:

•  Muscle pain at rest, especially at night

•  Cold or numb feet

•  Weak or no pulse in the affected limb

•  Pale, bluish-colored toes

•  Open sores on the lower leg, toes, or ankles

•  Shiny and hairless skin on affected areas

Illustration of arteries of the leg.

Arteries of the Leg

Causes, Risk Factors & Care

•  Smoking

•  Diabetes, especially in women. {Note: If you have diabetes and smoke cigarettes, you are very prone to peripheral vascular disease. If you have diabetes, YOU MUST NOT SMOKE.}

•  Fatty buildup (plaque) in the arteries High cholesterol

•  High blood pressure

•  Being elderly

•  Taking some medications, such as beta- blockers, to lower high blood pressure. {Note: Don’t stop taking any prescribed medicines on your own. Consult with your doctor.}

•  Agent Orange exposure

Treatment for peripheral artery disease includes:

•  A graduated exercise program, such as walking.

•  Medicines, such as ones to lower cholesterol and/or high blood pressure and to improve blood flow

•  Surgery, if needed, such as balloon angioplasty or bypass surgery

Prevention

•  Don’t smoke. If you smoke, quit.

•  Do regular exercise.

•  Get to and/or stay at a healthy weight.

•  Follow a diet low in saturated fat and cholesterol.

Self-Care

•  Follow measures under “Prevention” in this topic.

•  Follow a graduated walking program as advised by your doctor.

•  Take medicines as prescribed.

•  Take good care of your feet:

– Check the feet daily.

– Don’t walk barefoot.

– Wear comfortable, roomy shoes. Avoid sandals and high heels.

– Cut toenails straight across. Do not cut nails close to the skin.

– Use an antifungal foot powder to avoid athlete’s foot.

When to Seek Medical Care

Contact Doctor When:

•  You have any pain, redness, or a leg or foot wound and you have a history of diabetes or peripheral vascular disease.

•  The pain, redness, and swelling extend up the ankle to the leg.

•  The skin of your foot has turned grayish to black in color.

•  Repeated muscle pain occurs in a leg when you walk and it goes away with rest.

•  Leg pain occurs when you are at rest.

Get Immediate Care When:

You have all of these problems:

•  Sudden onset of pain

•  Rapid skin color changes: white, red, blue, grayish, or black

•  You cannot feel sensation in your foot for the first time.

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