Peripheral Vascular Disease

Peripheral Vascular Disease is a condition of the blood vessels that leads to narrowing and hardening of the arteries that supply the legs and feet. “It is estimated that peripheral vascular disease affects 30 percent of the adult population, and two-thirds of all cases are asymptomatic” (PubMed 1998). This paper will talk about the anatomy and physiology, etiology and pathophysiology, signs and symptoms, diagnostic and laboratory tests, and treatments about this disease.

Peripheral vascular disease is commonly located in the arteries of the lower extremities which include the femoral artery, iliac artery, popliteal artery, and tibial artery (emedicine 2010). The leading cause is from fatty material buildup within the vessels. This disease slowly inhibits the vessel walls causing them to be blocked, narrowed, or weakened (WebMD 2010). Other causes could be blood clots which block the blood vessels in the thrombus or emboli. Another is diabetes, because diabetes damages the blood vessels and make them become narrowed or weakened. Also inflammation of the arteries narrow and weaken the vessels. Several autoimmune conditions can develop vasculitis, and besides the arteries, other organ systems are also affected (WebMD 2010). Infections like syphilis and salmonellosis are known to infect and damage blood vessels. Structural defects occur at birth. A disease called Takayasu affects Asian females it affects the upper vessels of the body (WebMD 2010). Lastly, any injury to damage the blood vessels can cause peripheral vascular disease.

There are many signs and symptoms here are a few, pain in the calves, thighs, and hips, cramping in the legs, and leg or foot sores. Pain in the legs occurs while walking or climbing up stairs because the muscles’ need for blood increases during exercise. “The narrowed or blocked arteries cannot supply more blood, so the muscles are deprived of oxygen and other nutrients” (WebMD 2010). Cramping in the legs can be caused from exercising and when you rest the pain goes away this may be due to intermittent claudication. Intermittent claudication is pain that comes and goes, it feels like heaviness, tightness, or tiredness in the leg muscles. Leg pain at night is typical, usually the individual will hang their feet down to ease the pain and allow the blood to flow into the distal part of the legs (WebMD 2010). Leg or foot sores is another sign and symptom it’s where the sores don’t heal as fast as they would normally.

Tests that doctors perform to see if that person has peripheral vascular disease are rose criteria, treadmill exercise test, and an angiography. The first test is the rose criteria which it’s a series of 9 questions and the answers will indicate if that person has the disease and how severe it is (WebMD 2010). The second test is the treadmill exercise test doctors will take your blood pressure before and after exercise, or until a symptom occurs. If there is a significant drop in leg blood pressure and ABIs after exercise this suggests peripheral vascular disease (WebMD 2010). An Angiography maybe done to indicate where the blockages are in the blood vessels. “Angiography has for many years been considered the best test available and has been used to guide further treatment and surgery” (WebMD 2010). A dye is injected into the arteries and the dye highlights the blockages and narrowing of the arteries (WebMD 2010).

Medical treatments like angioplasty, pentoxiflylline, and cilostazol are some treatments they use. Angioplasty is where they insert a balloon in the blocked artery, they inflate the balloon pushing the plaque aside and the artery is widened so that it no longer restricts blood flow (WebMD 2010). Pentoxifylline is a medication to treat the symptom of intermittent claudication. It improves blood flow by decreasing the viscosity of blood and making red blood cells more flexible (WebMD 2010). Cilostazol is another medication used. It keeps the platelets from clumping together making the blood flow slow down. “It has been shown to increase walking distance by 35 to 109 percent” (American Family Physician 2006).

In conclusion peripheral vascular disease is a condition of the blood vessels that leads to narrowing and hardening of the arteries that supply the legs and feet. “It is estimated that peripheral vascular disease affects 30 percent of the adult population, and two-thirds of all cases are asymptomatic” (PubMed 2009). This paper has talked about the anatomy and physiology, etiology and pathophysiology, signs and symptoms, diagnostic and laboratory tests, and treatments about this disease.

References

Chahin, C. (2010, January 14). Anatomy. In Lower-Extremity Atherosclerotic Arterial Disease [Overview]. Retrieved from Department of Radiology, Aultman Health Foundation website: http://emedicine.medscape.com/article/423649-overview Federman DG, Trent JT, Froelich CW, Demirovic J, & Kirsner RS. (n.d.). Epidemiology of peripheral vascular disease: a predictor of systemic vascular disease. In pubmed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9697547 SONTHEIMER, D. L. (n.d.). American Family Physician. In American Academy of Family Physicans. Retrieved from Cox Family Practice Residency website: http://www.aafp.org/afp/2006/0601/p1971.html WebMD. (2005). Peripheral Vascular Disease. In WebMD. Retrieved from http://www.webmd.com/heart-disease/peripheral-vascular-disease?page=3