Atherosclerosis, or the build-up of fatty plaque in your blood vessels, is a systemic process affecting all of the arteries in your body. Therefore, the same medical conditions, like smoking, diabetes, high blood pressure, high cholesterol, obesity, that lead to blockages in the coronary arteries of the heart, also cause blockages in the arteries in the rest of your body.
If these blockages occur in your legs, you may experience pain, discomfort, or weakness in your calves or buttocks, which limit your activities. In severe cases, they can lead to ulcers, gangrene, and even amputations. In your carotid arteries, which supply the brain, atherosclerosis can lead to strokes. In the renal arteries, it can lead to kidney failure and high blood pressure. When atherosclerosis affects the aorta, aneurysms may form which can lead to tears and rupture.
Peripheral Artery Disease (PAD) is unfortunately very common and very under recognized. 8-12 million Americans are estimated to have PAD. However, only 15% of patients with PAD have typical symptoms and many patients with PAD have little or no warning signs and therefor do not receive treatment. It is critical to identify PAD in patients, both to treat the symptoms of PAD, and because over half of these patients also have coronary heart disease as well.
There are many resources and technologies available to diagnose and treat PAD. The physicians at Cardiac Specialists are expert in recognizing those who are at risk for or are showing early signs of vascular disease. We offer a wide range of screening and diagnostic testing for PAD in our offices, including Ankle Brachial Index (ABI) testing and vascular ultrasound of the leg, carotid arteries and aorta. We can arrange for and perform advanced testing, including CT or MRI scans, and angiography.
The mainstays of therapy for PAD are medication and lifestyle modification. Specific walking regimens prescribed by your physician can also improve your symptoms. Cardiac Specialists physicians also offer the latest minimally invasive cutting edge technologies to improve blood flow in your leg arteries, including angioplasty (balloon inflations to open the vessel, sometimes coated with medications to directly treat the blockages), atherectomy (devices to remove atherosclerosis), and stents.
Vascular disease can not only affect the arteries, which supply blood to your body, but can also affect the veins that return blood to your heart. These veins can become blocked, most commonly by blood clots. Over 2 million Americans each year develop these blood clots known as Deep Venous Thrombosis (DVT).
The most common causes of DVT are trauma to the legs, periods of immobility, or a genetic predisposition to form blood clots. DVTs can cause local pain and swelling in the affected limb. They are particularly dangerous if they travel to the lungs, where they are called pulmonary emboli (PE). Over 700,000 Americans suffer each year from PE, which can be a fatal condition.
Most DVTs are diagnosed by ultrasound and PE are diagnosed by a CT scan of the lungs. The primary therapy for DVT is blood thinning medication. In particular circumstances, it may be necessary to perform minimally invasive procedures such as thrombectomy, where blood clots are removed from the leg veins or lungs, or IVC Filters, which prevent blood clots from travelling to the lungs.
Please speak with your physician at Cardiac Specialists if you think you may be at risk for or are suffering from vascular disease such as PAD or DVTs.
** Drs. Taikowski and A. Pollack have specific expertise in the diagnosis and medical treatment of vascular disease. Drs. Fishman, Krichavsky, and Tuohy are additionally certified to perform minimally invasive procedures to improve blood flow in the peripheral circulation as well as in the coronary arteries.
1. Cardiosmart Video on Peripheral Artery Disease
Figure 3: Schematic of how blockages develop in peripheral arteries
Figure 4: Arrow points to a blockaged in blood of an artery