Peripheral artery disease (PAD) occurs in the lower extremities when there is a build up of plague in the arteries which leads of narrowing of the arteries. This is also referred to as atherosclerosis. PAD affects both men and women equally and affects about 8.5 million Americans in the United States every year (CDC, 2016). It is also more common in the Hispanic population compared to Caucasians (CDC, 2016).
According to the American Heart Association (2016), PAD the most common symptom is pain and muscle cramping in the legs, hips and calf muscles. Other associated symptoms include decreased temperature in the legs, lack of hair growth in the legs, crampy pain that does not go away, slow to heal leg or foot wounds and poor toe nail growth (AHA, 2016). These symptoms occur because if there is a blockage in the arteries then the blood cannot flow properly down through the legs and back up to the heart (AHA, 2016). Risk factors for patients that may develop PAD include smoking, aged over 60 years old, hypertension, diabetes, atherosclerosis and hyperlipidemia. Patients should be advised to control their hypertension, diabetes and hyperlipidemia and to quit using tobacco (CDC, 2016).
Physical examination will show a decreased in lower extremity temperature, weak peripheral pulses, compare blood pressure, changes in hair skin and nails. Then it is likely to have an ankle-brachial index exam, laboratory work to check for hypertension and hyperlipidemia, doppler studies, CT, MRI and Angiography of the extremities ordered for further evaluation and diagnosis. Treatment of PAD includes antiplatelet agents such as aspirin, smoking cessation, exercise and nutrition program and referral to vascular surgeon to correct serious blockages and referral to a cardiologist (Mahmoud et al., 2017). Patients should follow up with their specialist and primary care provider for medication management if they are on diabetes, blood pressure or cholesterol lower agents.
American Heart Association. (2016). Signs and symptoms of PAD. Retrieved from https://www.heart.org/HEARTORG/Conditions/VascularHealth/PeripheralArteryDisease /Symptoms-and-Diagnosis-of-PAD_UCM_301306_Article.jsp
Center for Disease Control. (2016). Peripheral artery disease fact sheet. Retrieved from https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_pad.htm
Mahmoud, A. N., Elgendy, A. Y., Rambarat, C., Mahtta, D., Elgendy, I. Y., & Bavry, A. A. (2017). Efficacy and safety of aspirin in patients with peripheral vascular disease: An updated systematic review and meta-analysis of randomized controlled trials. Plos One,12(4), e0175283. doi:10.1371/journal.pone.0175283