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Peripheral arterial disease, or PAD, is essentially cholesterol build up in the arteries outside of the heart. These arteries carry blood from the heart to other parts of the body and then back to the heart again. When cholesterol builds up in them, it narrows the path that the blood travels through, causing less blood to reach the needed body part. If sufficient blood is not flowing to a body part, it limits the amount of oxygen and nutrients needed by that body part and can cause permanent damage to it.

Peripheral Arterial Disease
Plaque Build Up Causing Peripheral Arterial Disease

Peripheral arterial disease can occur in any of the arteries throughout the body but is most commonly found in the arteries leading to your head, neck, arms, legs and internal organs. Peripheral arterial disease affects both men and women and it is estimated that about 6.5 million people over the age of 40 in the United States are currently living with peripheral arterial disease.

How Does Peripheral Arterial Disease Occur?

Many factors play into why someone may develop peripheral arterial disease (cholesterol build up in their arteries). It is a slow, life-long process that can begin as early as childhood for some individuals but often worsens at a higher rate as you age. 

Risk factors for peripheral arterial disease:

As stated above, coronary artery disease (CAD) increases your risk for peripheral arterial disease. Coronary artery disease occurs when cholesterol builds up in the arteries within your heart. This is different from peripheral arterial disease as peripheral arterial disease occurs in the arteries outside of your heart. The process for developing the two are the same: cholesterol slowly building up in your arteries; many times those with coronary artery disease have co-existing peripheral arterial disease. Coronary artery disease and peripheral arterial disease are so closely related that if you are diagnosed with coronary artery disease, you are about 50% likely to have peripheral arterial disease as well. This is why it is important to screen for both conditions simultaneously.

Symptoms of Peripheral Arterial Disease

Peripheral arterial disease can cause a variety of symptoms that act as warning signs from your body to tell you that something is wrong. Some of these symptoms may include:

  • Pain, cramping, tiredness or a heavy feeling in your legs. This may happen when you are walking and may improve when you rest, or you might feel it all the time.
  • Legs or feet feel cold to the touch
  • Dry or scaly skin on your legs or feet
  • Reddened or discolored skin on your legs or feet which can worsen over time
  • A wound on your leg or foot that does not heal
  • Diminished pulses in your legs or feet
  • Poor toenail growth
  • Hair loss on your legs
  • Arm pain with activity
  • TIA (transient ischemic attack) or stroke like symptoms
  • Abdominal pain after eating that is progressive
  • Progressive kidney dysfunction and difficult to control blood pressure
peripheral arterial disease causing leg pain

If you think you may have peripheral arterial disease, it is important to talk with your doctor. If left untreated or if the blood flow is completely blocked in an artery, the blockage can permanently damage that part of the body. Identifying and treating peripheral arterial disease is critical to preventing / lowering your risk of conditions associated with peripheral arterial disease like stroke, loss of limbs or dysfunction to your internal organs. 

How Do I Prevent Peripheral Arterial Disease? 

Prevention of peripheral arterial disease is similar to the prevention of heart disease:

  • Exercise regularly
  • Control your blood pressure
  • Control your diabetes
  • Stop smoking
  • Eat a healthy diet
  • Take your medication as prescribed
peripheral arterial disease management

If you fear you may be at risk for peripheral arterial disease, it is important to talk with your doctor. Although peripheral arterial disease is a lifelong condition, your doctor can talk with you about ways to slow the progression of it and improve your quality of life. 

Diagnosing Peripheral Arterial Disease

peripheral arterial disease test using Ankle-Brachial Index Test
Ankle-Brachial Index Test (ABI)

If your doctor suspects that you have peripheral arterial disease, he or she will probably measure the blood pressure in your arms or legs (ABI) or perform an ultrasound. Both of these tests are noninvasive and will suggest to your doctor if you have a blockage. If either of these suggest that you have a blockage, your physician will order an angiogram, a test where dye is put inside the suspected blocked blood vessel to show if it is blocked. An angiogram is the most conclusive way to diagnose peripheral arterial disease.

It is recommended that you get tested for peripheral arterial disease if you fall under the following categories:

  • 65 or older (even with no symptoms)
  • 50 or older with a history of diabetes or smoking
  • Under the age of 50 if you have diabetes or other peripheral arterial disease factors such as obesity or high blood pressure
  • Anyone with a history of coronary artery disease

Treating Peripheral Arterial Disease

peripheral arterial disease cardiologist consultation

Treating peripheral arterial disease includes a combination of diet, exercise, smoking cessation, medications and the potential for an angioplasty to help the affected blood vessel. An angioplasty is similar to placing a stent inside of your heart but it is done in a blood vessel in your leg, abdomen or arm.

If you are living with peripheral arterial disease, regular exercise, smoking cessation and adherence to your medications according to how they were prescribed are crucial in the long term management of the disease. We recommend talking with your doctor about possible medications and treatments that are right for your personal medical history and diagnosis. 

We hope this KHC University post has been helpful and interesting as you learn more about peripheral arterial disease. If you have any specific topics you would like to learn more about in KHC University, suggest a topic here! We love hearing topic suggestions from our readers! 

Thank you for reading this KHC University post and as always, thank you for letting us Kare for your heart!

Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram (TEE) is an invasive heart procedure where an ultrasound probe is inserted into your esophagus (food pipe). A transesophageal echocardiogram allows your cardiologist to acquire detailed pictures pertaining to the structure, function and any valvular heart disease that many be present. This procedure demonstrates your cardiac function in much greater detail than a standard transthoracic echocardiogram.

Prior to your procedure, you should not have any food or drink for 8-12 hours. In most cases, you will be able to take your home medications as scheduled. Your cardiologist / healthcare provider will advise you if there are any requirements to alter your medication schedule. Prior to your transesophageal echocardiogram, the technologist will insert an IV in your arm as a safety precaution to begin the test. This will allow sedation to be given to make you more comfortable during your procedure. During your procedure, you will be required to lie flat for approximately 30 minutes while the test is being completed. After your transesophageal echocardiogram, you will need to refrain from driving for approximately 12 hours and will need someone to accompany you home after the procedure. You can return to your normal activities the morning after your procedure.