PAD and Heart & Stroke


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PAD does not refer to the soft cushion on the bottom of your feet. PAD is Peripheral Artery Disease, a buildup of cholesterol and plaque in the arteries that lead to the extremities. When cholesterol buildup blocks the arteries to the heart, the condition is called coronary artery disease (CAD).  In fact, PAD and CAD are associated with a single disease – atherosclerosis – a buildup of cholesterol in the arteries throughout the entire body increasing the risk for heart disease. The simplest test for PAD is having a podiatrist or a physician check for the pulses in your feet during a physical assessment of the foot.  In each foot, there should be two pulses easily detected by a trained health care professional.  The pulses are indicative of the blood flow to your feet.  PAD can cause discomfort and even pain in your legs and feet and can limit walking and other activities. Severe PAD can even progress to loss of limb if untreated.  It’s serious.


Symptoms


While many people with peripheral artery disease have mild or no symptoms, some people have leg pain when walking (claudication).


Claudication symptoms include muscle pain or cramping in your legs or arms. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is the most common location.

The severity of claudication varies widely, from mild discomfort to debilitating pain. Severe claudication can make it hard for you to walk or do other types of physical activity.

Causes

Peripheral artery disease is often caused by atherosclerosis.  Less commonly, the cause of peripheral artery disease may be blood vessel inflammation, injury to your limbs, unusual anatomy of your ligaments or muscles, or radiation exposure.

Risk Factors

  • Factors that increase your risk of developing peripheral artery disease include:
  • Smoking
  • Diabetes
  • Obesity (a body mass index over 30)
  • High blood pressure
  • High cholesterol
  • Increasing age, especially after reaching 50 years of age
  • A family history of peripheral artery disease, heart disease or stroke
  • High levels of homocysteine, a protein component that helps build and maintain tissue

People who smoke or have diabetes have the greatest risk of developing peripheral artery disease due to reduced blood flow.

Peripheral artery disease symptoms include:

  • Painful cramping in your hip, thigh or calf muscles after certain activities, such as walking or climbing stairs (claudication)
  • Leg numbness or weakness
  • Coldness in your lower leg or foot, especially when compared with the other side
  • Sores on your toes, feet or legs that won't heal
  • A change in the color of your legs
  • Hair loss or slower hair growth on your feet and legs
  • Slower growth of your toenails
  • Shiny skin on your legs
  • No pulse or a weak pulse in your legs or feet

If peripheral artery disease progresses, pain may even occur when you're at rest or when you're lying down (ischemic rest pain). It may be intense enough to disrupt sleep. Hanging your legs over the edge of your bed or walking around your room may temporarily relieve the pain.

Complications 

If your peripheral artery disease is caused by a buildup of plaques in your blood vessels (atherosclerosis), you're also at risk of developing:


Critical limb ischemia. This condition begins as open sores that don't heal, an injury, or an infection of your feet or legs. Critical limb ischemia occurs when such injuries or infections progress and can cause tissue death (gangrene), sometimes requiring amputation of the affected limb.

Stroke and heart attack. The atherosclerosis that causes the signs and symptoms of peripheral artery disease isn't limited to your legs. Fat deposits also build up in arteries supplying your heart and brain.


Prevention

The best way to prevent claudication is to maintain a healthy lifestyle. That means:

                                  • Quit smoking if you're a smoker.
                                  • If you have diabetes, keep your blood sugar in good control.
                                  • Exercise regularly. Aim for 30 minutes several times a week.
                                  • Lower your cholesterol and blood pressure levels, if applicable.
                                  • Eat foods that are low in saturated fat.
                                  • Maintain a healthy weight.
                                  • See a podiatrist and maintain the yearly family physician check up.



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