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://veno.com.hk
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.
