Peripheral Artery Disease Common, Manageable
Peripheral artery disease, or PAD, is a common circulatory problem that affects more than 12 million people in this country. Caused by atherosclerosis the buildup of plaque in the arteries PAD affects the blood vessels of the lower extremities. Interventional cardiologist Murali Muppala, M.D., says that the risk factors for PAD are similar to those for coronary artery disease and the condition is most common in people age 50 and older. Anything that increases the risk of plaque buildup in the blood vessels can increase the risk of PAD, Dr. Muppala says.
Specific risk factors include:
- Increase in low-density lipoprotein (LDL) bad cholesterol and triglycerides and a decrease in highdensity lipoprotein (HDL) good cholesterol
- Diabetes Hypertension high blood pressure
- Family history
- Lack of exercise
- Chronic kidney failure
Dr. Muppala says 50 percent of people with PAD do not experience symptoms, but if and when they do, they can include leg cramping and heaviness with activity that gets better with rest.
Other common symptoms include:
- Hair loss
- Numbness in the legs
- Legs feeling cold
- Loss of calf muscle mass
- Change in color with elevation or dangling of legs
- Painful ulcers in the toes
Diagnosis can be done by a simple physical examination or a noninvasive test, like ankle-brachial index (ABI), which compares the blood pressure between the arm and the affected leg. Other noninvasive tests include ultrasound, CT and magnetic resonance angiogram (MRA). Angiography is the gold standard for diagnosis, Dr. Muppala says.
Using small plastic tubes inserted in the groin, we inject iodine contrast into the blood vessels, which allows us to view the blood flowing through the arteries. There is a wide range of treatment options for PAD, says general and vascular surgeon John Moss, D.O.
Less invasive options may be available, like supervised walking programs and lifestyle modification like smoking cessation, weight reduction and controlling diabetes, high blood pressure and cholesterol, Dr. Moss says. There also are medications that improve blood flow. Other, more invasive treatment options include removing plaque from the arteries, angioplasty or bypass surgery.
PAD is a lifelong condition that requires the medical management of underlying risk factors, lifestyle modification and the coordination of care from specialized physicians.
To learn more about Lee Memorial Home Health, call 239-418-2900 or email HomeHealth@LeeMemorial.org.
John Moss, D.O.
General & Vascular Surger
Lee Physician Group
8380 Riverwalk Park Boulevard
Fort Myers, FL 33919
Murali Muppala, M.D.
Lee Physician Group
14051 Metropolis Avenue
Fort Myers, FL 33912