The FAQs of Peripheral Arterial Disease (PAD)

10 Things You Should Know about Peripheral Artery Disease
By Dr. Lee Yates

If you are suffering from leg pain, burning or aching in your calves or a wound in your foot or leg that won’t heal, you may have peripheral artery disease. Also known as PAD, this condition that affects 8-12 million Americans can cause leg tiredness, cramping and pain when walking. PAD also raises the risk of heart attack, stroke, leg amputation and death.

Since September is PAD Awareness month, it is a great time to explore this topic. If you suspect you or a loved one may have PAD, consider these frequently asked questions about the disease:

1. What is PAD?
This is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop PAD, your extremities — usually your legs — don’t receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking. PAD is also likely to be a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis). This condition may be reducing blood flow to your heart and brain, as well as your legs.

2. What is the most common symptom of PAD?
The first symptom that most people notice is muscle pain. Depending on where the artery blockage is, the pain may affect different muscles in the calf, thigh, buttock, hip and/or foot.

3. Are there other signs and symptoms of PAD?
Some people experience numbness, achiness, or heaviness in the leg muscles when walking or climbing stairs. Other symptoms may include sores or wounds on the toes, feet or legs that heal poorly or not at all; coldness in the lower leg or foot, especially when compared with the other side; no pulse or a weak pulse in the legs or feet; skin on the legs that is shiny, pale or bluish; poor toenail growth; decreased hair growth on the legs and, in men, erectile dysfunction, especially among those who have diabetes.

4. What are the factors that might increase the risk of developing PAD?
People who smoke or have diabetes have the greatest risk of developing PAD due to reduced blood flow. Other risk factors include obesity; high blood pressure (140/90 millimeters of mercury or higher); high cholesterol (total blood cholesterol over 240 milligrams per deciliter, or 6.2 millimoles per liter); increasing age, especially after reaching 50 years of age; a family history of PAD, heart disease or stroke; and high levels of homocysteine.

5. Aren’t leg pain and numbness often a normal part of aging?
Don’t dismiss any symptom as a normal part of aging. PAD can be caught early by recognizing risk factors using readily available screening tools.

6. How is PAD managed?
Sometimes, surgery is necessary to minimize the risk for heart attack or stroke. Common management methods include medications that lower cholesterol or prevent blood clots; diabetes management; lifestyle change, such as quitting smoking; exercise programs; and regular follow-up care.

7. My symptoms don’t seem that bad. Why should I worry about it?
If you have undiagnosed PAD and systems continue to worsen, blocked blood flow can cause gangrene (tissue death), and in very serious cases, this can lead to leg amputation. PAD also increases your risk of coronary heart disease, heart attack and stroke.

8. Is PAD curable?
Although PAD is serious, it’s treatable. If you have the disease, see your doctor regularly so he or she can treat the underlying atherosclerosis to slow or stop disease progress and reduce the risk of complications. Treatments include lifestyle changes, medicines, and surgery or procedures. Researchers continue to explore new therapies for PAD.

9. What happens during the PAD screening?
The PAD screening is a quick, easy and non-invasive procedure called the ankle-brachial index (ABI) test. It is done by measuring blood pressure at the ankle and in the arm while a person is at rest.

10. Can PAD cause other health problems?
PAD may be the first warning sign of atherosclerosis – chronic fatty deposit build-ups – throughout your arteries. The whole circulatory system, including your heart and brain, are at risk when arteries are blocked and narrowed. Fatty deposits also increase the risk for vascular inflammation and blood clots that can block the blood supply and cause tissue death.

Although peripheral artery disease is potentially a life-threatening condition affecting one out of every 20 Americans over the age of 50, the good news is PAD can be managed or even reversed with proper care.

A member of the Georgia Vascular Society and a Fellow of the American College of Surgeons, Dr. Lee Yates is the Medical Director of Vascular Surgery at St. Joseph’s Candler Health System

Dr. Lee Yates, Medical Director of Vascular Surgery at St. Joseph’s Candler Health System and founder of Savannah Surgery Center

Dr. Lee Yates, Medical Director of Vascular Surgery at St. Joseph’s Candler Health System and founder of Savannah Surgery Center

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