Peripheral Vascular Disease

Palm Beach Gardens Medical Center is your heart and vascular care destination in Palm Beach Gardens, FL. We are committed to helping you understand your condition so you can get the care you need. Not all cardiovascular diseases are felt as pain in the chest. Other parts of the body may start showing signs of a cardiovascular condition.

For instance, during physical activity, one of the first signs of peripheral artery disease (PAD), a type of peripheral vascular disease, can be painful cramps in the buttocks and legs. This pain may go away during rest. However, up to 4 out of 10 people with PAD do not experience leg pain. With PAD, cramps, aches or discomfort while walking can occur in the thigh, hip or calf.

What Is Peripheral Vascular Disease?

Peripheral vascular disease is an umbrella term that includes lymphatic disease, peripheral venous disease and PAD. It is often used interchangeably with PAD. The American Heart Association recommends the term PAD to describe a disease affecting the blood vessels outside the heart.

Atherosclerosis is a condition where there is plaque buildup in arteries, causing them to become narrowed or blocked and preventing the oxygenated blood from reaching the rest of the body. PAD affects the arteries that supply blood to the arms, legs or feet. As people age, they are at increased risk of developing PAD. Other PAD risk factors include:

• Age above 60 years
• Diabetes
• High blood pressure
• High cholesterol
• Smoking

Other disorders or conditions affecting the arteries may have symptoms like PAD; not all PAD is caused by atherosclerosis. People with PAD are at risk of developing cerebrovascular and coronary artery disease, which could lead to stroke or heart attack. Atherosclerosis can affect other arteries in the body. This condition has different names depending on which arteries are affected:

Peripheral Vascular Disease Symptoms

Since working muscles need more blood flow than resting muscles, a symptom of PVD is painful muscle cramping in the legs when walking, exercising or climbing stairs. The pain is a warning sign that the muscles do not get enough blood for their needs. Some people with PVD mistake their pain for something else or do not feel symptoms. PVD symptoms include:

• Gangrene
• Poor toenail growth
• Decreased leg hair growth
• Impotence
• Toe or foot wounds that heal very slowly or do not heal
• The affected leg or foot has a lower temperature than the rest of your body
• Weakness, heaviness or numbness in muscles
• A bluish or pale color to the skin
• Thickened, opaque toenails

Types of Peripheral Vascular Disease

Here are the two major categories of peripheral vascular disease (PVD):

Occlusive PVD – caused by blockage in the blood vessels

• Atherosclerosis – the buildup of fatty deposits (plaque) in the arteries, narrowing the arteries and reducing blood flow.


• Buerger’s disease – wherein blood vessels swell, preventing blood flow and causing clot formation. It can lead to tissue damage, pain and even gangrene.


• Carotid artery disease – the narrowing of the carotid arteries, the main blood vessels carrying oxygenated blood to the brain.


• Deep vein thrombosis – blood clots in the veins found in the leg which can dislodge and travel to the lungs and heart, resulting in pulmonary embolism or blockage of the lung artery


• Lymphedema – swelling of some parts of the body due to lymph buildup. Lymph is a fluid in the lymphatic system traveling through the body to fight disease.

Functional PVD – blood vessels narrowing and widening due to other factors, such as stress, cold temperatures, smoking, or work involving vibrating tools.

• Chronic venous insufficiency (CVI) - blood pooling in the legs because the vein vales do not work properly, preventing blood from the legs from returning to the heart


• Raynaud’s disease – arteries spasm and temporarily restrict blood flow


• Varicose veins – enlarged, twisted veins visible under the skin and caused by venous insufficiency

Diagnosing Peripheral Vascular Disease

We may use several procedures to diagnose PVD at Palm Beach Gardens Medical Center. Diagnosis usually starts with asking patients about their medical history and having them undergo a physical exam or ultrasound. Other diagnostic procedures include:

• Ankle-brachial index - comparing the blood pressure in the ankle with the blood pressure in the arm


• Computed tomography angiography (CTA) - a form of imaging that uses a dye injected into the blood vessels, allows the doctor to watch blood flow through the arteries as it happens


• Doppler ultrasound - the use of sound waves to show blood flow through blood vessels


• Magnetic resonance angiography – the use of radio waves, a computer and a powerful magnetic field to evaluate blood vessels


• Peripheral angiography - the use of contrast dye and X-rays to identify narrowed or clogged arteries that supply blood to your limbs
  

Peripheral Vascular Disease Treatment

Our PVD treatment focuses on reducing symptoms and preventing PVD from worsening, such as through lifestyle changes, medications and exercise. 

• Stop smoking – smoking is a major PAD factor and increases your risk for stroke and heart attack. Work with us to discover programs and medications that may help you quit smoking.


• Physical activity – our rehabilitation program includes a supervised exercise routine you can do to help ease symptoms. Simple leg exercises, walking regimens and treadmill workouts can help, too.


• Diet – aim for a diet low in trans-fat and saturated fat to lower your blood cholesterol levels. Emphasize fruits, vegetables and whole grains in your diet while including low-fat dairy, fish, legumes and more.


• Medication – prescribed medications may include:
  • Anti-platelets to prevent blood clots
  • Medications to lower cholesterol
  • High blood pressure medications

Procedures

If the abovementioned treatments do not improve a patient’s condition, we may recommend minimally invasive treatment or peripheral vascular surgery. Here are some procedures we perform:

• Angioplasty or stent placement – procedures that involve making a small incision where a catheter will be inserted to reach the clogged artery. A tiny balloon will be inflated to open the blocked artery.


• Atherectomy – a minimally invasive procedure to remove plaque blocking the artery. A catheter with a cutter at the end will be inserted to cut and remove the plaque from the blood vessel.


• Bypass surgery – if a patient experiences severe symptoms and an extended portion of their leg blood vessel is completely blocked, bypass surgery may be needed, especially if other minimally invasive techniques are no longer possible. Bypass surgery is a peripheral vascular surgery procedure that aims to reroute blood flow around the clogged artery by using a vein taken from another part of the patient’s body.

Your Heart Is in Good Hands

Leg pain, numbness or other symptoms should not be dismissed as normal aches and signs of aging. Early diagnosis and treatment of PVD are important to protect your health and decrease your risk of heart attack or stroke. We can help you improve your quality of life with the right treatments, often without extensive surgical operations or extended hospital stays.

When it comes to your heart, you need someone you can trust. Our Heart and Vascular Institute has delivered advanced cardiac care to our community for nearly four decades. We were the first hospital in Palm Beach County and the Treasure Coast to perform open-heart surgery, and we’ve remained one of the area’s leading heart hospitals ever since.