Peripheral vascular disease -- under diagnosed and dangerous

Thursday , March 06, 2014 - 9:04 AM

Christopher Kim, MD, Standard-Examiner Columnist

An estimated 10 million adults in the United States are affected by peripheral vascular disease and many of them do not even know it.

Even worse, patients who have relatively minor peripheral arterial disease symptoms face a five-year mortality rate of up to 30 percent from primarily cardiovascular causes (stroke, heart attack). Almost one-third of patients with peripheral arterial disease die within a five-year period.

What is peripheral vascular disease?

Peripheral vascular disease (PVD) is disease of the blood vessels located outside the heart and brain. When an artery develops significant plaque buildup, the results can be disastrous. The proper medical term for a blockage is stenosis, and the disease process causing these blockages is called atherosclerosis.

Atherosclerosis is a gradual process of hard cholesterol substances (plaques) building up on arterial walls. These plaques narrow openings, sometimes obstructing blood flow. The clogging can start in the teen years from poor diet, smoking and lack of exercise. As we get older and the blockages become more severe, symptoms may begin to appear.

What Are the Signs and Symptoms?

Symptoms and signs depend on the disease progress. In milder cases, symptoms could be aches and pains in the legs — just from walking or mild exercise. Other milder symptoms include leg heaviness and fatigue, particularly with walking. With more severe blockages, in order to sleep, patients may drop the leg over the side of the bed for comfort, not knowing they are simply using gravity to help blood flow through a partially blocked artery.

More dramatic consequences of atherosclerotic disease are strokes and heart attacks. However, peripheral vascular disease is under-diagnosed and under-treated. If you have blockages in one part of your body, chances are extremely high you have blockages in other parts.

There are risk groups — such as diabetics — we assume already have the disease, but there are other groups who are potential candidates for the disease because of other risk factors. These include:

• Smoking. The arterial wall lining (endothelium) constantly fights the good fight. The chemicals in tobacco smoke actually stun the endothelium and breaks down an important line of defense against atherosclerosis.

• Hypertension. Higher blood pressures mean stiffer blood vessels and more turbulent blood flow that can damage the vessels and contribute to blockages.

• Sedentary lifestyle. Contributes to obesity and leads to diabetes, hypertension and high cholesterol.

• Diet. Goes hand-in-hand with a sedentary lifestyle.

• Age. We can’t do anything about age, but we certainly can keep the body healthy through proper diet, exercise and treatment of risk factors. Don’t use age as an excuse. The older we get, the more aggressive we need to be about proper health maintenance.

Caught early, treatment for peripheral vascular disease is relatively simple. It could be a prescription of diet, exercise and/or medication. Initial screening is simple, quick and non-invasive. The more advanced the disease, the more involved the treatment and screening.

Dr. Kim is a Interventional Cardiologist at Utah Cardiology with privileges at Davis Hospital. He is a graduate of the University of Cincinnati College of Medicine and the University of Texas Medical School at Houston. He can be reached at 801-776-0174.

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