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Q: Is leg pain the main symptom of PAD?


A: 
Peripheral artery disease (PAD) is the preferred clinical term for describing stenosis or occlusion of upper- or lower-extremity arteries due to atherosclerotic or thromboembolic disease.  In practice, the term PAD generally refers to chronic narrowing or blockage of the lower extremities. The most common cause is a build-up of plaque caused by cholesterol in the arteries.

About 20-50% of patients diagnosed with PAD are ASYMPTOMATIC, though they usually have functional impairment when tested. Up to 4 in 10 people with PAD experience NO leg pain.  

How does PAD manifest?

PAD represents a wide spectrum of disease severity, encompassing both asymptomatic and symptomatic disease.
As the disease progresses and blood vessels narrow, arterial flow into the lower extremities worsens, and symptoms may manifest either as:

  • classic intermittent claudication (IC), leg muscle discomfort provoked by exertion that is relieved with rest OR as
  • atypical claudication or leg discomfort, which is lower extremity discomfort that is exertional but does not consistently resolve with rest.

About 10 to 35 percent of all PAD patients report symptoms of classic IC, and 40-50 percent of patients present with the atypical form.

What are the symptoms?

  • painful muscle cramping in the hips, thighs or calves when walking, climbing stairs or exercising. The pain often goes away when you stop exercising, although this may take a few minutes.
  • Leg numbness or weakness
  • Coldness in your lower leg or foot, especially when compared with the other side
  • Sores on your toes, feet or legs that won’t heal
  • Dry or discolored feet.
  • Hair loss or slower hair growth on your feet and legs
  • Slower growth of your toenails
  • No pulse or a weak pulse in your legs or feet. These are all signs of poor circulation.

What roles does AGE play and what are the main risk factors?

The prevalence of PAD is lower among younger patients, such that estimates of asymptomatic or symptomatic PAD among patients 45 to 64 years of age is about 3%.
Given that PAD represents a more systemic atherosclerotic process that is similar to atherosclerotic disease of the coronary vessels, it is not surprising that PAD shares SIMILAR RISK FACTORS:

older age (over 50), usually male, diabetes, smoking, hypertension, high cholesterol, weight, and renal insufficiency. Other risk factor: a family history of PAD.

Unfortunately, PAD is known to be associated with a reduction in functional capacity, quality of life and an increased risk for myocardial infarction, stroke, and death.

PAD often goes undiagnosed by healthcare professionals as many doctors associate the symptoms with other diseases or aging.

Left untreated, PAD can lead to gangrene and amputation, therefore making it vital to report to the doctor at an incipient stage of the disease.
You may need to be screened for PAD if you are:

  • Over 60
  • Over 50 and have a history of diabetes or smoking
  • Under 50, but have diabetes and other peripheral artery disease risk factors, such as obesity or high blood pressure.

Don’t let leg pain stop you from enjoying life. Come see our vascular specialists in Port St. Lucie. Call (772) 353-4727 to schedule a free leg screening today.

 

Source: https://www.cdc.gov/heartdisease/PAD.htm
https://effectivehealthcare.ahrq.gov/products/peripheral-artery-disease-treatment/research-protocol

 

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