Cardiovascular News

Raising Awareness of Peripheral Vascular Disease

Do you have leg pain or trouble walking? Sometimes these problems are thought of as "something I have because I am getting older." But they can be signs of a serious circulation problem called peripheral vascular disease, or PVD. PVD is a disease of the blood vessels in areas outside the heart. Often, PVD affects the arteries that carry blood to the legs and arms.

Like atherosclerosis, PVD is caused by the buildup of fatty deposits — called plaque — in the arteries. Having blocked arteries can keep oxygen-rich blood from reaching the muscles when the muscles need it most. This lack of oxygen causes the pain. PVD can increase your risk of heart attack and stroke. But the good news is that PVD can be easy to diagnose and is treatable.

Although PVD is common, many people don't know about it. A survey by the National Council on the Aging showed that two thirds of people over age 50 are unaware of the disease. At LifeBeat Online, we want to inform you about PVD — to help you learn if you are at risk and what you can do about it.

8 to 12 Million People in the United States Have PVD*

That ../includes 12% to 20% (4.5 to 7.6 million) of those over 65.
By 2050, a projected 19 million people could have PVD.

Could I Have PVD?

One of the classic symptoms of PVD is dull, cramping pain in the legs, hips, or buttocks that happens when you exercise. This pain stops when you rest — a symptom called intermittent claudication. Some people with PVD have pain even when they are not exercising.

Other symptoms of PVD include:

Numbness or tingling in the legs, feet, or toes
Changes in skin color (pale, bluish, or reddish coloration)
Cool skin (for example, in the legs, feet, arms, or hands)
Impotence
Infections/sores that do not heal

Symptoms usually appear in the part of the body that has blocked arteries. But people with PVD can also be symptom-free. So it is important to be aware of your risk. View our PVD risk checklist.

I Have Symptoms, But How Do I Know if It Is PVD?

If you have symptoms or think you may be at risk, get screened for PVD. You can get screened at your doctor's office. The tests for PVD can be quick and painless — as simple as a blood pressure measurement.

The most common test for PVD is the ankle-brachial index (ABI). The ABI compares the blood pressure in your legs and arms (brachial means "of the arm") using a blood pressure cuff. If the pressures are different, it could mean you have PVD.

If the ABI shows that you may have PVD, your doctor may do other tests. The following tests can help show the location of the blocked artery and how serious the blockage is.

Duplex Doppler ultrasound — This test uses sound waves to create a picture of the arteries. This type of ultrasound can also show if blood is flowing smoothly through the arteries.
Magnetic resonance imaging (MRI) — Radio waves in a magnetic field are used to create flat or three-dimensional pictures of the arteries. If you have a pacemaker or implantable cardioverter defibrillator (ICD), be sure to check with your doctor before having an MRI.
Angiography — For this test, you are given a local anesthetic. Then, a special dye is injected into the artery through a small tube called a catheter. The dye shows up on x-rays and helps determine which arteries are narrowed or blocked.
Computerized tomography angiography (CTA) — For CTA, the dye is injected into a blood vessel, and x-rays are taken from different angles. Then, a computer analyzes the x-rays to form a three-dimensional picture of the arteries.

PVD Can Be Treated

Treatment for PVD depends on how severe the disease is. So, it can be a great advantage to find PVD early. The solution is often simple. For example, your doctor may recommend exercise or medications. Exercise can cause new, tiny blood vessels to grow and bring oxygen to problem areas. Your doctor can prescribe medicines to reduce pain or prevent blood clots. Also, medicines may be needed to control diabetes, high blood pressure, or high cholesterol because these conditions, if not treated, can increase the risk for PVD.

Your doctor may decide it is necessary to treat the blocked arteries. One or more of these procedures could be used to help blood flow freely again through the affected arteries:

Angioplasty — A catheter with a balloon is passed through the blocked artery. Once inflated, the balloon compresses the plaque against the wall of the artery.

Stent implantation — During angioplasty, a tiny metal mesh tube called a stent may be placed in the artery to help hold it open.

Atherectomy — A special catheter is used to gently shave and remove plaque from the arteries.

Bypass surgery — A healthy blood vessel taken from another part of the body, or a small man-made tube, is used to create a detour to allow blood to flow around a blocked artery.

The Consequences of Not Treating PVD Can Be Very Serious

People with PVD can have a six- to seven-times higher risk of heart attack and stroke. And about one third of patients with PVD who have a heart attack or stroke die from it. Also, if PVD is not treated, the symptoms can get worse. It may become very difficult and painful to get around. Severe PVD may even cause serious infections that can result in the loss of a limb. If you think you may be at risk, ask your doctor whether you should be screened.

Free Screenings Are Available

The Guidant Foundation is proud to support Legs for Life — National Screening Program for PVD Leg Pain. This program, founded by the Society of Interventional Radiology in 1997, is dedicated to identifying patients at high risk for PVD. About a quarter of a million people have been screened so far. One in four was found to be at risk for PVD.

Free screenings will be available in hundreds of hospitals, clinics, and senior centers across the country in September. For more information about PVD and Legs for Life screening sites, visit www.legsforlife.org.

* American Heart Association. Heart Disease and Stroke Statistics — 2004 Update.

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