Peripheral arterial disease (PAD) or Peripheral artery disease is a condition in which blood flow to the legs is blocked due to narrowing of the blood vessels originating from the heart (arteries). As a result, limbs that lack blood supply will feel sore, especially when walking.
Peripheral artery disease sometimes causes no symptoms and develops slowly. If left untreated, peripheral arterial disease can worsen to the point of tissue death, and risk amputation.
This disease is triggered by various conditions due to an unhealthy lifestyle, such as hypertension, diabetes, and high cholesterol. Therefore, the most effective way to prevent peripheral artery disease is to live a healthy lifestyle, namely by eating a balanced nutritious diet and exercising regularly.
Symptoms of Peripheral Artery Disease
At first, people with peripheral artery disease do not experience any symptoms, or only have mild symptoms, such as cramping, heavy limbs, numbness, or pain. The pain that is felt will get worse when the patient is active (eg walking or climbing stairs), and will subside after the patient rests. This condition is also known as claudication.
Claudication in the elderly should not only be considered a normal complaint due to aging. Immediately consult a doctor if you experience these symptoms, especially if you are over 50 years old, smoker, suffer from diabetes, hypertension, or high cholesterol.
Because if left unchecked, over time the arteries will narrow and cause complaints in the form of:
- Feet feel cold and blue (appear pale).
- There are sores on the legs that don't heal.
- Feet blackened and rotted.
These complaints are a sign of tissue death and are at risk for amputation. This tissue death can be widespread if not treated immediately.
In addition to claudication and tissue death, the following symptoms can also be signs of peripheral artery disease:
- Leg hair loss
- Reduced leg muscles
- Brittle and slow growth of toenails
- Erectile dysfunction in men
Causes of Peripheral Artery Disease
Similar to coronary heart disease and stroke, peripheral artery disease is caused by a buildup of fat in the walls of blood vessels. In peripheral artery disease, this buildup occurs in the arteries that supply blood to the legs.
Fat deposits can make the arteries narrow, so that blood flow to the legs becomes blocked. This process is also known as atherosclerosis, and it can occur in any part of the body.
Although rare, peripheral artery disease can also be caused by inflammation of the arteries and injury to the legs.
Peripheral Artery Disease Risk Factors
Naturally, arteries will harden (arteriosclerosis) and narrow with age (especially after age 50), but this process can occur more quickly in people with the following conditions:
- Obesity
- Diabetes
- Smoking habit
- Hypertension
- High cholesterol
- Diseases with high homocysteine levels (hyperhomocysteinemia)
- Have a family member who has peripheral artery disease, coronary heart disease, or stroke.
Peripheral Artery Disease Diagnosis
From the symptoms complained of, the doctor will perform a physical examination, especially feeling the pulse in the legs and examination ankle-brachial index (ABI). ABI aims to compare blood pressure in the ankle with blood pressure in the arm. Lower blood pressure in the ankles can signal peripheral artery disease.
To be sure, the doctor will run a follow-up examination in the form of:
- Doppler ultrasound
Doppler ultrasound can be used to see the condition of blocked arteries in the legs, using sound waves as the medium.
- Angiography
Angiography is done by injecting contrast fluid into a vein before taking a CT scan or MRI image. The goal is that the picture of the blood vessels on the results of the examination becomes clearer and more detailed.
- blood test
The doctor will take a sample of the patient's blood to measure cholesterol or blood sugar levels, which can increase the risk of developing peripheral artery disease.
Peripheral Artery Disease Treatment
Treatment of peripheral arterial disease aims to treat symptoms, so that patients can return to their previous activities. Treatment is also carried out to prevent the deterioration of atherosclerosis, so that patients avoid heart attacks and strokes.
Patients will be advised to stop smoking, do regular exercise 30 minutes a day (5 days a week), and maintain an ideal body weight. These steps will be combined with:
Omedicine
To treat peripheral arterial disease, patients may need only 1-2 of the following drugs, or they may need to take all of the following drugs:
- medicine for cholesterol, e.g. simvastatin. This drug works to lower cholesterol.
- medicine for hypertension, For example, ACE inhibitors. This drug is given to lower blood pressure.
- medicine for diabetes, e.g. metformin. This drug is given to lower blood sugar levels.
- blood thinners, such as aspirin or clopidogrel. This drug works to prevent the buildup of blood clots in narrowed arteries.
- Drugs to dilate blood vessels, eg cilostazol or pentoxifylline. This drug restores blood flow back smoothly.
Operation
If the drugs are ineffective and the pain is very severe, surgery by a vascular surgeon will be performed to restore blood circulation in the leg. The types of operations that can be performed are:
- Angioplasty
Angioplasty is performed by inserting a small balloon, along with a catheter, to widen the narrowed artery.
- Operation bypass blood vessel
Operation bypass blood vessels is done by taking blood vessels from other parts of the body, to be an alternative route for blocked blood vessels.
- Thrombolytic therapy
Thrombolytic therapy is a procedure of injecting clot-dissolving drugs directly into narrowed arteries.
Complications of Peripheral Artery Disease
Lack of blood intake can cause infections or sores in the legs, especially in the toes that do not heal. This condition can worsen and lead to tissue death or gangrene, requiring amputation.
As said earlier, the process of atherosclerosis can also occur in the blood vessels of the heart and brain. If left unchecked, this condition will lead to dangerous complications, such as stroke or heart attack.
Coronary Heart Disease Prevention
The most effective way to prevent peripheral artery disease is to prevent atherosclerosis, namely by:
- Quit smoking.
- Eat a balanced nutritious diet.
- Regular exercise 30-45 minutes per day, 3-5 days a week.
- Maintain ideal body weight.
- Reduce consumption of alcoholic beverages.
- Follow the doctor's advice to treat diabetes, hypertension, or high cholesterol.