Peripheral Vascular
It’s a condition with several names and several potentially serious outcomes. People often use the terms peripheral vascular disease (PVD) and peripheral artery disease (PAD) interchangeably for this disorder.
What is Peripheral Vascular Disease?
PVD is an umbrella term. It refers to all diseases of blood vessels found outside the heart or the brain. It can affect both a patient’s arteries and veins, according to HealthyWomen.org. Most often, people using the term are referring to PAD, which is a narrowing or occlusion caused by plaque in the arteries.
Risk factors include diabetes, hypertension, being overweight or obese, smoking, inactivity and an elevated blood cholesterol level, MedicineNet.com reports. Among those older than 50, around 5 percent suffer from this condition.
The disorder is most frequently associated with the legs. Although symptoms vary according to where the problem occurs and the degree of vessel blockage, the most common sign is pain that occurs while walking but that goes away at rest. Potential complications include ulcers, sores that won’t heal, infections and even gangrene.
Treatment alternatives include lifestyle changes, angioplasty, medications, surgery or a combination of these options. Often the treating physician is a vascular specialist or a cardiologist who specializes in peripheral vascular problems.
According to the National Heart, Lung, and Blood Institute, primary care doctors can sometimes care for patients with a mild peripheral vascular disorder. However, with a more advanced case of PAD, they’re likely to refer the patient to a vein clinic.
Diagnosing Peripheral Vascular Problems
An evaluation begins with a medical and a family history, followed by a physical exam to look for signs of a peripheral vascular disorder. The doctor will check blood flow to the legs or feet and for absent or weak pulses. Other steps include comparing blood pressure between both legs and looking for signs of poor healing of any wounds or changes in the skin, hair or nails that could suggest a problem.
Healthcare professionals rely on a number of tests for a definitive diagnosis. ABI (ankle brachial index testing) compares blood pressure in the ankle to that in the arm to determine whether blood flow in a limb is sufficient.
Vascular specialists use various types of ultrasound. The carotid Doppler ultrasound examines the inside of the carotid arteries, while aortic duplex ultrasound evaluates the aorta. A doctor might opt to use upper and lower extremity arterial and venous ultrasound. Other diagnostic tools include a treadmill test, a magnetic resonance angiogram, an arteriogram and various blood tests to check for peripheral vascular risk factors.