Peripheral arterial disease (PAD) is a chronic disease usually due to
atherosclerosis, when the atheromatous plaque cause thickening of the
arterial wall, resulting in narrowing or occlusion of the arteries. This
problem can occur in all arteries from the body, but one of the
commonest site is the arteries of the legs.
What are the risk factors of PAD?
The following are the risk factors of atherosclerosis and its associated
diseases which could increase the risk of developing cardiovascular and
cerebrovascular diseases.
These include:
- Aging (over 50 years old);
- Smoking;
- High cholesterol;
- Diabetes;
- High blood pressure;
- Chronic kidney disease;
High plasma levels of homocysteine elevated fibrinogen concentration;
Personal history of vascular disease, heart attack or stroke, and
Family history of premature atherosclerosis.
Patients with PAD are suggested to have evaluation and control of
underlying cardio and cerebrovascular diseases, and atherosclerosis risk
factors.
Clinical Classification of PAD
The varieties of signs and symptoms present help doctor to stage the
severity of PAD for patients. The most commonly used methods are the
Fontaine and Rutherford classification which classify the disease based
on the following 4 categories of symptoms:
Asymptomatic: Most of the patients are asymptomatic, but with
clinical examination such as palpation and checking the Ankle-Brachial
Index (ABI) may reveal cold extremities, and other signs of incomplete
blood vessels obstruction.
Intermittent Claudication (IC): Fatigue;
heaviness; tiredness or cramping in the lower extremity precipitated by
walking or exercise and relieved with rest. The location of the pain
depends on the site of occlusion of the artery, but the commonest site
is at the calf.
Critical Limb Ischaemia (CLI): Leg pain persist even at rest;
decrease temperature of leg; toe or leg sores, wounds that do not heal,
or heal very slowly; loss of hair on the skin; brittle nail, with absent
or diminished pulse in the legs. Patients in this condition must be
referred to a vascular surgeon ASAP to prevent limb loss.
Ulceration or gangrene: Minor to major tissue loss due to severe
arterial occlusion, with non-healing wound in foot & ankle, or the
toes turn black in color. Patients with this condition must be urgently
referred to a vascular surgeon for revascularization in order to salvage
the limb.
Reference information:
http://esteemmedical.com.hk/peripheral-arterial-disease-cause.html It
is not intended as medical advice to any specific person. If you have
any need for personal advice or have any questions regarding your
health, please consult your doctor for diagnosis and treatment.
