Peripheral vascular disease (PVD) is a condition in which plaque buildup causes a narrowing of the arteries to your legs. The case study is a typical example of PVD in patients with diabetes. PVD is 20 times more common in people with diabetes than in the general population. Other risk factors are smoking, lack of exercise, high blood pressure, high blood lipid levels (including cholesterol), and obesity. Women with diabetes are just as much at risk, and the disease is not limited to the elderly. It depends on genetics and how long you have had diabetes. It is a serious disease that needs to be recognized and treated.
What Are The Symptoms Of PVD?
Symptoms that indicate the need for a vascular evaluation include claudication (pain in the calves while exercising); pain at rest; night pain; and ulceration, gangrene, or inability to heal after minor foot surgery. Claudication is the inability to walk a given distance, usually stated in the number of city blocks (one block = 75 yards), because of muscle pain or cramping due to inadequate blood supply. The location of the muscle groups involved helps your physician distinguish whether the blockage is in the arteries (inflow) or veins (outflow). The higher up the involved muscles are, the higher the blockage is. Claudication is made worse by an incline or a faster pace, and it is almost always relieved by rest. PVD must also be distinguished from nerve irritation such as arthritis, a herniated disk, tarsal tunnel syndrome, or neuropathy itself. In the case study, HG’s claudication was an early sign of insufficient blood flow in the affected leg. He also had neuropathy.
Intermittent claudication does not mean you are going to lose the limb, especially in its early stages. Only 10-15% of patients go on to more limb-threatening symptoms. Some patients with diabetes, especially those who smoke, may progress more rapidly. Progressive claudication with walking less than 1/2 to 1 city block or that interferes with your lifestyle or work indicates a need for a vascular consultation and treatment. Limb-threatening symptoms include pain at rest and tissue loss. Patients with impaired circulation to their legs and feet tend to describe a deep, aching pain in the foot, which feels better with the support of the area.
How Is PVD Diagnosed?
The physician must assess poor circulation in your legs and feet. In population-based studies, 20-30% of patients had absent foot pulses. Also, hair growth, skin and nail texture, pallor of the foot when elevated, redness of the foot when it hangs down, and the appearance and the temperature of the affected foot compared with the other foot are important to consider. There are no laboratory tests that will always measure the degree of poor circulation or predict healing. This includes Doppler pressures, ankle-arm blood pressure ratios, toe pressures, waveform analyses, pulse-volume recordings, laser Doppler, transcutaneous (skin) oxygen determination, and MRA. Arteriography (dye studies of the arteries) is indicated when there are ulcers or wounds that fail to heal and areas that repeatedly break down despite therapeutic shoes.
Blood flow can be checked by feeling arterial pulses in the feet and legs. When pulses are diminished or absent, noninvasive Doppler arterial testing is performed to determine the differences in blood pressures from the foot to the thigh.
Pressures can be compared to the opposite side and to the arm to locate potential sites of arterial blockage in the leg.
Janice is a practicing nurse at a leading hospital in the state of Arizona. She has been writing articles in her free time discussing on how getting consultation from online doctor works .