Peripheral Arterial Disease (PAD)
At Suffolk Heart Group we specialize in the treatment and diagnosis of peripheral arterial disease (PAD). Considered one of the top cardiology practices on Long Island, with over 40 years of experience, we have the depth and expertise to diagnose and treat all stages of PAD.
What is PAD?
Peripheral Arterial Disease or PAD is when the arteries, most commonly in the lower extremities (legs) are narrowed or become hardened which prevents sufficient blood flow in the areas affected. If an artery is completely obstructed because of the hardening of the artery or if a piece of cholesterol, blood clot, or calcium breaks off the lining of the artery and blocks the artery, the organ that artery supplies blood to will be damaged.
Unfortunately, the disease is progressive and most people will be unaware that they have this because they do not experience symptoms until at least 60% of the artery has narrowed. Another reason PAD patients are asymptomatic (without symptoms) is because their body, to compensate for the compromised arteries, will create new and smaller vessels around the damaged ones to supply blood and oxygen called collateral circulation.
The rate and severity of PAD depends on the individual and his risk factors, including pre-existing factors and lifestyle.
If left untreated, PAD can result in the patient developing Critical Limb Ischemia (CLI) which is when the legs and feet have such severe blockage that they are not receiving any blood or oxygen required for growth and repair of sores. This can lead to death of tissues called gangrene and if not treated, may require amputation.
What Are Some PAD Symptoms?
The most common symptom of PAD is leg cramping or pain during walking called claudication. Others might experience numbness, heaviness, or weakness in the legs. These symptoms in patients with PAD subside at rest.
Other symptoms, when PAD is more severe, include pain in the feet and toes at rest and especially at night when lying flat for long periods of time.
Symptoms may also include loss of hair and changes in skin color, toe or foot sores that do not heal, and/or cooling of the skin in specific areas of the feet and legs.
Still others are asymptomatic and these individuals are at higher risk of suffering early heart attacks or strokes. If you have PAD, your chances of dying from heart disease, are six times higher than those who do not. This is why it is very important to consult your physician if you are experiencing any of these symptoms or have multiple risk factors.
What Are Some PAD Risk Factors?
- Smoking: it is the leading risk factor in PAD.
- Diabetes
- Increasing age especially for those over 50.
- Obesity
- Family history of heart disease
- High blood pressure or hypertension
- High cholesterol levels
- Elevated Homocysteine levels: An amino acid found in blood plasma
What Happens Once I Am Diagnosed with PAD?
Most people diagnosed with PAD will not need invasive treatment like surgery. And your chances of having an amputation as a result of PAD are 1 in 20. There are several things you can do to slow down the progression of PAD once you are diagnosed.
- Smoking cessation
- Exercise therapy: this type of therapy is exercise specifically designed for someone with PAD and should be done in a supervised setting like a cardiac rehabilitation program that focuses on walking.
- Lifestyle modifications that involve lowering your hypertension and cholesterol levels if these are high.
- Medications including those that lower your blood pressure and cholesterol
- Diabetes management
- Foot care
- Some people may require an endovascular treatment approach like stents, angioplasty, or even surgery.
What Is Endovascular Therapy?
There are several endotherapy approaches. These include stents, angioplasty, and surgery.
- Stents are expandable wire mesh tubes that are inserted into the narrowed arteries. Once inserted, they can expand, opening the artery and allowing blood flow into that artery.
- Angioplasty is a procedure where a tiny balloon is inserted into the narrowed artery. Once in, liquid is put in the balloon allowing it to expand. Once the artery is opened, the balloon is deflated and removed.
- Surgery is done by re-routing the blood from above an area of blockage to below the blockage, using either a piece of synthetic material, or the patient's own vein.
Get Screened!
PAD on the Vascular Disease Foundation
The Suffolk Heart Group has some of the best and most experienced cardiologists on Long Island who diagnose and treat peripheral arterial disease (PAD). If you are diabetic, experience leg cramps, or weakness then you should be screened for peripheral arterial disease. Interestingly, most patients with peripheral arterial disease never have symptoms until the disease is severe. With proper screening and intervention (usually medical) peripheral arterial disease can be treated successfully. Call today to make an appointment for PAD. screening.
