Peripheral Artery Disease (PAD) Lecture Notes

Definition and Causes

• Peripheral Artery Disease (PAD): A common circulatory condition where peripheral arteries are narrowed, reducing blood flow.
• Commonly Affected Area: Lower limbs.
• Major Cause:
  • Atherosclerosis: Plaque buildup (lipids, fibrous tissue, calcium) in arteries.
• Less Common Causes:
  • Sudden artery block by blood clot or embolus.
  • Blood vessel inflammation, injury, unusual anatomy of ligaments or muscles.

Symptoms and Effects

• Ischemia: Reduced blood flow impact is significant during physical activities.
  • Intermittent Claudication:
    • Pain or tired feeling in legs during walking, relieved by rest.
  • Other Symptoms:
    • Loss of color and cold feet, especially when elevated.
    • Lack of toenail and hair growth.
  • Pain Location: Depends on site of obstruction; calf is most common.
• Advanced Stage: Critical Limb Ischemia
  • Pain during rest, slow or non-healing ulcers, tissue death, gangrene.
  • Increased risk of limb loss.
• Acute Limb Ischemia: Sudden block of blood flow, usually due to embolism or thrombosis. Considered a medical emergency.

Risk Factors

• Factors increasing atherosclerosis risk also increase PAD risk.
• PAD patients may also have coronary or carotid artery disease.

Diagnosis

• Based on symptoms, medical history, physical exam, and tests.
• Physical Exam:
  • Look for weak pulses, whooshing sounds, poor wound healing.
• Blood Tests: Evaluate cholesterol, triglyceride, blood sugar levels.
• Ankle Brachial Index (ABI) Test:
  • Compares blood pressure in ankle and arm.
  • ABI < 0.9 indicates PAD.
• Imaging Procedures: Identify affected arteries.

Treatment

• Goals: Relieve symptoms, restore blood flow, prevent atherosclerosis progression.
• Options:
  • Lifestyle changes and exercise programs.
  • Medications.
  • Procedures to open or bypass arterial blockages.
• Objective: Reduce risk of limb loss, heart attack, and strokes.