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Doc Talk Doc Talk: The dangers of peripheral vascular disease

  • Published Monday, Sep. 24, 2012, at 10:21 p.m.

We think of blood clots as dangerous when they affect the heart, causing a heart attack, or the brain, causing a stroke. But most people do not realize the dangers of blood clots that develop in other parts of the circulatory system.

Peripheral vascular disease — also known as peripheral arterial disease — is the hardening of the arteries outside the chest. In people older than 50, a buildup of plaque often occurs in blood vessels of the legs and the carotid arteries in the neck. The result is decreased blood flow to a territory beyond the blockage. Decreased blood flow in the legs reduces circulation and can cause fatigue when walking or open sores that don’t heal. In the carotid artery, the blockage can result in a stroke or transient ischemic attack.

Peripheral vascular disease affects about 8 million people in the United States, including an estimated 12 to 20 percent of Americans ages 65 and older. Over the age of 80, 26 percent of men and 20 percent of women are affected.

Risk factors are the same as those for heart disease. Smoking is the greatest risk factor, and individuals who smoke and also have diabetes are at greatest risk. Other risk factors include heart disease, a family history of heart disease or peripheral arterial disease, high blood pressure, high cholesterol and lack of exercise.

Symptoms of peripheral arterial disease in the legs include aching in the calves or hips that occurs when exercising, such as when walking or climbing stairs, but subsides after a short period of rest, usually less than five minutes. Cramps may occur when the leg is fatigued because of reduced flow in the muscle beyond the blocked artery. (Leg cramps at night often are caused by low calcium or vitamin D levels or because of low potassium in patients who take diuretics, unrelated to peripheral arterial disease.) Other symptoms are sores on the legs or feet that don’t heal and lack of feeling in the legs or feet. When an artery is partially blocked, the feet may feel cold and painful.

Symptoms of blockage in the carotid arteries in the neck are similar to those of stroke. They might include temporary loss of vision in one eye, a feeling of dizziness or transient numbness or weakness on one side of the body.

Peripheral arterial disease can be treated just as blocked coronary arteries are treated. Common treatments include lifestyle changes, medications and exercise programs. If the disease is advanced, angioplasty, clot-dissolving drugs or bypass surgery may be necessary.

It’s important to talk with your doctor if you experience any of these symptoms or if you have risk factors for peripheral arterial disease. A Doppler ultrasound exam can measure the blood flow and help to detect peripheral arterial disease.

Just remember, prevention and early detection are the keys to avoiding a crisis.

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