Penn Heart and Vascular

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Friday, August 2, 2013

Detecting and Treating Peripheral Artery Disease

Emile R. Mohler III, MD, professor of medicine and director of vascular medicine at Penn Medicine, discusses how peripheral artery disease is diagnosed and treated.

Peripheral artery disease (PAD) is common in the U.S., affecting almost 10 million people.

PAD occurs when arteries become narrow or blocked, decreasing blood supply in the legs. It’s caused by a buildup of plaque in the walls of arteries called atherosclerosis. PAD typically occurs in the legs, but it also may affect arteries that carry blood from the heart to the kidneys, head, arms or stomach. People with PAD have greater risk for coronary artery disease, heart attack and stroke.

What are the signs and symptoms of PAD?

Classic symptoms of PAD typically include pain, fatigue or discomfort in the feet and legs that occurs during walking or exercise and then goes away after a few minutes of rest. Others with the disease may show signs of:
  • Sores on legs or feet that heal slowly or not at all
  • Skin that looks dark and blue
  • Lower temperature in one leg compared to the other
  • Weak or absent pulse in the legs or feet
  • Erectile dysfunction
PAD may be diagnosed following a complete medical history, physical examination and diagnostic tests. One of the most commonly used tests is the ankle-brachial index, which compares blood pressure in the ankle to blood pressure in the arm. Other studies that could be done to determine where a blood vessel is blocked include ultrasound of arteries, a magnetic resonance angiography test or computed tomography (CAT scan) angiography test.

What is the treatment for PAD?

Treatment for PAD is based on severity of the disease, risk factors and test results. Lifestyle changes that can help control PAD include:
  • not smoking
  • eating a healthy diet
  • lowering blood pressure
  • controlling cholesterol
  • exercising regularly – walking at least 30 minutes for three days each week or 10,000 steps per day
Medications to treat underlying conditions may be prescribed, such as statins to lower cholesterol or ACE inhibitor to reduce blood pressure. Surgical procedures such as angioplasty or bypass may also be recommended to open the blocked arteries.

Penn’s Vascular Medicine Program is conducting peripheral artery disease research studies to improve circulation in the legs of patients with PAD.

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