Understanding Peripheral Artery Disease

Oct 13, 2024

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.