Peripheral vascular disease (PVD) is a problem with poor blood flow. It affects blood vessels outside of the heart and brain and gets worse over time. Parts of the body, like the brain, heart, arms, or legs, may not get enough blood. The legs and feet are most commonly affected.

Other blood vessel problems like deep vein thrombosis (DVT), varicose veins, and chronic venous insufficiency are linked to PVD.

PVD is often found in people with problems with the arteries that supply blood to the heart (coronary artery disease). That is because atherosclerosis, which causes coronary artery disease, affects arteries throughout the body. Atherosclerosis is the buildup of plaque on the walls of the arteries. Plaque is made up of cholesterol, fat, and waste from the cells, and other materials. It causes the arteries to become stiff and narrow.

Causes:

PVD may result from a narrowing of the blood vessels that carry blood to the legs and arms. The most common cause is atherosclerosis.

Other causes of PVD may include injury to the arms or legs, abnormal muscles or ligaments, or infection.

conditions are linked to PVD:

The term peripheral vascular disease encompasses several different conditions including:

•             Atherosclerosis. Atherosclerosis is the buildup of plaque inside the artery wall. Plaque is made up of deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin. The artery wall then becomes thickened and loses its elasticity. Symptoms may develop gradually, and may be few, as the plaque builds up in the artery. However, when a major artery to the heart or brain is blocked, a heart attack or stroke may occur.

•             Buerger disease (thromboangiitis obliterans). This is a chronic inflammatory disease in the arteries. It leads to blood clots in the small- and medium-sized arteries of the arms or legs, eventually blocking them. This disease most commonly occurs in men between ages 20 and 40 who smoke cigarettes. Symptoms include pain in the legs or feet, clammy cool skin, and a diminished sense of heat and cold.

•             Pulmonary embolism (PE). PE is a blood clot in the lungs. The most common cause is a part of a clot that breaks off and travels to the lungs. In the lungs, the clot can cut off the flow of blood. This is a medical emergency and may cause death. Common symptoms are chest pain, trouble breathing, fast heartbeat, sweating, coughing (may cough up blood), and fainting. If you have these symptoms, call 911 or get emergency help.

•             Varicose veins. Dilated, twisted veins are caused by valves that allow backward flow of blood. This allows blood to pool. It's most commonly found in the legs or lower trunk. Symptoms include bruising and sensations of burning or aching. Pregnancy, obesity, and extended periods of standing make symptoms worse.

Risk factors include:

•             Age over 50 years

•             Heart disease

•             High blood cholesterol

•             High blood pressure (hypertension)

•             Diabetes

•             No longer having menstrual periods (postmenopausal)

•             Family history of high cholesterol, high blood pressure, or PVD

•             Overweight or obesity

•             Physical inactivity

•             Smoking or use of tobacco products

symptoms of PVD:

About half of the people diagnosed with PVD do not have symptoms. The most common symptom is lower leg cramps with activity that stop with rest (intermittent claudication). It may occur in 1 or both legs.

Other symptoms may include:

•             Changes of the skin of the legs and feet, including red to blue color, coldness, or thin, shiny skin

•             Weak pulses in the legs and the feet

•             Dead tissue due to lack of blood flow (gangrene)

•             Hair loss on the legs

Diagnosis

To diagnose PVD, your health care provider will do a complete medical history and physical exam. Other tests may include:

•             Angiography. A procedure that allows the health care provider to see blocked or narrowed blood vessels. This procedure involves inserting a thin, flexible tube into an artery in the leg and injecting a contrast dye. The contrast dye makes the arteries and veins visible on the X-ray.

•             Ankle-brachial index (ABI). An ABI is a comparison of the blood pressure in the ankle with the blood pressure in the arm. It helps to diagnose PVD and checks for changes in blood flow over.

With Regards,
John Mathews
Managing Editor
Journal of Phlebology and Lymphology