April 13, 2021 by John Fernandez
Knowing You Have PAD (Peripheral Artery Disease) Could Save Your Life … Or Limb
Most patients with peripheral artery disease (PAD) have never heard of the disease until they are diagnosed. What makes this surprising is that some 8.5 million Americans have PAD, according to the American Heart Association. And even more concerning is that it can be as life-threatening and life-changing as a heart attack or other cardiovascular condition.
“This is a serious disease,” says Ian Del Conde, M.D., a cardiologist and vascular medicine specialist who treats PAD patients at Miami Cardiac & Vascular Institute. “Everyone with PAD has a high risk of a heart event. Aggressive prevention measures are necessary.”
PAD occurs when blood vessels narrow due to the build up of plaque, known as atherosclerosis. The plaque sticks to the artery walls and can eventually block blood from reaching organs and the rest of the body. It is commonly found in the legs, and if left untreated, can lead to amputation.
“Many patients don’t have symptoms, or don’t take note of them, so their disease goes undetected ― until they have a heart attack or stroke or develop gangrene and risk losing a limb,” Dr. Del Conde explains.
Fortunately, Miami Cardiac & Vascular provides a variety of treatments to prevent PAD from worsening and offers the newest technologies to restore blood flow, if intervention is needed. It also hosts one of the premier annual medical conferences that brings together the world’s best specialists to discuss cutting-edge PAD treatments and other breakthroughs.
Who is At Risk?
Anyone can get peripheral artery disease. But there are some risk factors that can make you more prone to PAD, including smoking, high blood pressure and cholesterol, atheroslcerosis and being 60 or older. Diabetics and Blacks also have a higher rate of PAD than others.
“Everyone should be having a conversation with their primary care provider about PAD,” Dr. Conde says. “We should be looking at patients’ feet and taking ankle-brachial pulses.” Testing the pulse in the ankles allows a physician to determine if blood is flowing normally down the legs. If blood pressure in the ankles is weak, further testing may be suggested.
What are the Symptoms?
While most people have few or no symptoms, some notice that when they walk or exercise, their legs bother them. “They don’t often use the word pain,” Dr. Del Conde says. “They are more likely to say their legs are tired.”
Some patients report cramps in the calf, thigh or buttocks. It’s important to get checked out if you experience muscle aches, cramps or numbness in your legs or hips. Don’t assume your condition is just an issue of aging, arthritis or something orthopedic.
How is PAD Treated?
If you are diagnosed with PAD, your treatment will depend on its severity, location and your general health. Physicians first want to ensure that your disease does not progress, so patients are often put on steroids, as well as medications to lower blood pressure and cholesterol. You may also be given medications to prevent the formation of a blood clot, which can occur when a blood vessel narrows. Finally, you may be asked to make lifestyle changes, such as quitting smoking, losing weight if you are overweight, exercising more and drinking more water.
Options for interventions include a minimally invasive procedure called angioplasty, where a small catheter is threaded through an artery in the groin to the blockage and a balloon is inflated, pushing the plaque against the artery walls. Some patients may need an atherectomy, where plaque is removed from the artery. In either case, a tiny mesh and metal tube, or stent, may be left in place so that the vessel remains open. Others may undergo a bypass procedure, using a blood vessel from another part of the body or a synthetic vessel.
What Should You Do?
If you’re having any kind of recurring pain or discomfort, if you have diabetes or other risk factors, talk to your healthcare professional. It could save your life or limb. “Awareness has been increasing,” Dr. Del Conde says. “But more needs to be done.”
Miami Cardiac & Vascular Institute leads and participates in numerous clinical trials involving PAD and other cardiovascular problems. For more information on trials, click here.