Also referred to as peripheral vascular disease claudication vascular disease or leg cramps from poor circulation Ruth Townsend MS Director Health amp Wellbeing Solutions PAD is similar to coronary artery disease except it affects the legs stomach ID: 775404
Download Presentation The PPT/PDF document " Peripheral Artery Disease (PAD)" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Slide2Peripheral Artery Disease (PAD)
Also referred to as peripheral vascular disease, claudication, vascular disease, or leg cramps from poor circulation Ruth Townsend, MSDirector, Health & Well-being Solutions
Slide3PAD is similar to coronary artery disease, except it affects the legs, stomach, vital organs, arms, and head Most commonly occurs in the arteries of the legs Caused by the build up of plaque in the arteries that carry blood to you head, organs, arm and legsPlaque is also called atherosclerosisMade up of fat, cholesterol, calcium, fibrous tissue, and other substances
What is Peripheral Artery Disease (PAD)
Slide4PAD: Arteries that Can be Affected
Slide5Normal and Atherosclerotic Arteries
Slide6PAD increases your risk for coronary heart disease, heart attack, stroke, TIA – it might be the first warning signDangerous because it restricts circulation to the limbs, organs and brain. Without adequate blood flow legs, feet, arms, brain and vital organs suffer damagePain, numbnessHave difficulty fighting infection – gangrene, tissue death
Why Does PAD Matter?
Slide7The most common cause of PAD is atherosclerosis caused by plaque build up. Atherosclerosis may develop when certain factors damage the inner layers of the arteries. These are risk factors:Cigarette smoking: STOP!!! Smokers may have 4x the risk of PAD than non-smokers; is considered main risk factor for PADObesity – Reduce your weight, try to achieve and maintain normal weight. People with BMI of 25 or higher are more likely to develop heart disease and stroke even if they have no other risk factors
Understanding the Cause and Your Risk for PAD
Slide8Diabetes – If you have diabetes manage it and your blood sugars. People with diabetes are at a much greater risk of developing PAD and other cardiovascular diseasesPhysical inactivity – Get moving now! Physical activity increases the time or distance one can walk without pain; also helps decrease risk of heart disease or strokeHigh Blood Pressure – Manage with medications, diet and exercise , and stress management
Understanding the Cause and Your Risk for PAD (cont)
Slide9High Cholesterol – Manage your cholesterol levels with medications, diet and exercise. High cholesterol contributes to the plaque build up in the arteries and can significantly reduce blood flowAge-Plaque builds up in your arteries as you age, combined with other risk factors like smoking or diabetes, puts one at an even higher riskPeople who smoke and/or have diabetes are at especially high risk
Understanding the Cause and Your Risk for PAD (
cont
)
Slide10The most common symptoms of PAD involving the lower extremities are painful cramping, pain or tiredness in the calf, thigh or hip muscles while walking, climbing stairs, or exercising This is called claudication. Because the pain or cramping typically goes away with rest, but comes back again with exercise, it is called intermittent claudicationWorking muscles need more blood flow than resting muscles
Symptoms of PAD
Slide11Claudication pain, cramping, or other discomfort varies from individual to individual. Some have severe debilitating discomfort while other have minimal symptomsThe severity depends on: how many arteries are affected, how narrowed (blocked) the arteries are, and how many collateral or secondary vessels are availableHow quickly you walk and whether you walk on an incline or up stairsClaudication location:In the upper 2/3 of the calf is usually due to PAD in the main artery of the thigh, superficial femoral arteryLower 1/3 of the calf is due to disease in the popliteal artery behind the kneeUpper thigh pain results from blockage in the superficial femoral artery, common femoral artery or iliac arteryButtock pain results from blockage in the abdominal aortaFoot pain results from blockage in the tibial or peroneal arteries
Location of PAD Determines the Location of Pain
Slide12Diagnosis of PAD (Claudication) is based upon signs and symptoms and confirmed with non-invasive tests:Ankle-Brachial (arm) Index – resting BP at ankle compare to BP in the arm. Ankle systolic divided by arm systolic = Index. .9-1.3 is normalImaging:Ultrasound- see which areteries are blocked and whereCT- good if patients have pacemaker ot stentMRA – like CT but don’t use xRays
Diagnosis of PAD
Slide13Medical therapyReduce Risk Factors:Medication to lower/manage cholesterol, high blood pressure, diabetes,Anti-platelet agents (Aspirin and Plavix)Exercise – 45-60 min at least 3x/week; supervised betterMedication to improve walking distanceCilostazolRevascularizationAngioplasty and StentingSurgery
Treatment for PAD
Slide14Lifestyle ChangeModify lifestyle in conjunction with medical treatmentIncrease physical activityModify dietManage stressSee handout
Treatment for PAD (cont)
Slide15Reduce risk factors – modify lifestyleBe physically active – walkBe screened for PAD
Prevention of PAD
Slide16American Heart Association. August 2014NIH. November 2015UpToDate. March 2015
References