Peripheral Artery Disease
Living With PAD
Patients living with peripheral artery disease (PAD) must be aware of several things. Because of blockages or decreased blood flow to leg muscles, feet and toes, these body parts must be protected. Blood not only heals, but it maintains health by providing oxygen and nutrients to the skin, cells and muscles.
If decreased blood flow leads to a small sore or ulcer, this can become a big problem with slow and poor healing, leaving a door open to infection, the development of a chronic, non-healing ulcer and even potential amputation if gangrene (skin/tissue death) occurs. Therefore, it is recommended that if you have PAD, you never walk barefoot, wear proper fitting shoes and examine your feet daily for any redness, sores or areas of concern.
You may need to use a mirror to see the soles of your feet or have a family member assist. Feel all around the foot for bumps, sores or tenderness. Seeing a podiatrist on a regular basis may also be advised depending on how advanced the PAD is and what risk factors are present.
In PAD, circulation is decreased due to the buildup of plaque in the arteries. This buildup is made up of primarily cholesterol, calcium and other debris. This is the same disease process that blocks the arteries in the heart (causing heart attacks), neck (causing strokes) and elsewhere. If you have PAD, you have a much higher risk of also having blockages in other arteries throughout the body that can lead to heart attack and stroke. It is recommended that you discuss your own individual risk for these potential consequences with your doctor.
Your doctor may want to perform an ECG, a stress test, or even a Doppler ultrasound depending on your history. PAD is treated medically to help reduce the risk of a heart attack or stroke, as well as slow any progression of PAD. Medications may also preserve your ability to be active, stabilize blockages already present and try to make the blood flow as efficient as possible. You should not smoke and you should eat a low-fat, low-cholesterol, heart-healthy diet.
PAD can also slowly rob you of your ability to be active. Your muscles need oxygen and blood to work, provide strength and balance. If blood flow is limited, so is your ability to be active. You may notice various symptoms of claudication, such as heaviness in your legs or intense cramping while walking a certain distance or at a particular speed.
If you feel you are limited in what you can do, or have noticed a decrease in how far or fast you can walk, your circulation may have worsened and you should speak to your doctor. At more advanced stages of PAD, rest pain can occur when your legs are elevated at night due to extremely poor blood flow and the lack of gravity to assist with circulation. If you have rest pain, it will occur most nights and can severely compromise your activity level.
In summary, if you find you’ve had a decline in function (e.g., less active or able to keep up), it could be due to development or progression of PAD. While there is no cure for PAD, you can lessen your risk of consequences by taking prescribed medications, maintaining a healthy lifestyle, staying active, not smoking, and knowing when to address any issues that may arise.
Published: November 2015
Medical Contributors & Reviewers: Mirvat Alasnag, MD, BCh, King Fahd Armed Forces Hospital; Anne Albers, MD, FACC, Ohio Health; Herbert Aronow, MD, MPH, FACC, Brown University; Wobo Bekwelem, MD, University of Minnesota Hospital & Clinics; Neal Bhatia, MD, Emory University School of Medicine; Jaafer Golzar, MD, FACC, Advocated Christ Medical Center; Keyur Mavani, MD, Community Medical Center and Moses Taylor Hospital; Khusrow Niazi, MBBS, FACC, Emory University; Andrew Roy, MD, ICPS; Michelle Sloan, NP, Eastlake Cardiovascular Associates; Suthipong Soontrapa, MD, Texas Tech University.