Peripheral Vascular Disease - Diagnosis and Treatment

Peripheral vascular disease (PVD) is a narrowing of the blood vessels (arteries) that carry blood from the heart to other parts of the body. It usually occurs in the legs, but can also affect arteries in the neck, arms, kidneys or stomach.

Peripheral vascular disease is caused by the buildup of plaque deposits on the insides of artery walls. These deposits or clumps cause the arteries to narrow, weaken and become partly or completely blocked, which reduces the flow of blood to the affected area.

Risk factors for peripheral vascular disease include:

• Smoking
• Diabetes
• Older age
• High blood pressure
• High blood cholesterol
• Overweight or obesity
• Family history of coronary artery disease

Symptoms of PVD develop slowly and may be mistaken for other conditions at first. The most common symptom is leg pain that starts when walking. The pain may stop at rest (intermittent claudication). Other symptoms include:

• Tiredness
• Heaviness or aching in the legs
• Leg numbness
• Changes in leg skin color (pale or blue) or temperature (cool)
• Leg sores or skin ulcers that don’t heal
• Male erectile dysfunction, especially when diabetes is also present
• Hair loss on legs or slower growth of leg hair or toenails

Many people have no symptoms at first or mistake symptoms for another condition. The pain of PVD is felt in the muscles, not the joints, as is the case in arthritis. Some or all of the following may be used to diagnose PVD:

• Physical exam and medical history
• Ankle-brachial index (ABI)
• Doppler and ultrasound imaging
• Blood tests
• Treadmill test
• Magnetic resonance angiogram (MRA)
• Arteriogram
• CT angiography

Treatment is aimed at reducing symptoms, preventing complications such as heart attack or stroke, and improving quality of life.

Lifestyle adjustments include:

• Exercise program as prescribed by your doctor
• Quitting smoking
• Eating a heart-healthy diet

Medications may include:

• Cholesterol-lowering drugs
• Blood thinners
• Blood pressure drugs
• Drugs to ease leg pain

In severe cases vascular surgery may be considered.