Legs Cramp When You Walk? It May be a Sign of PVD

Peripheral Vascular Disease (PVD) is a common circulation that involves the narrowing of vessels that carry blood away from the heart.  It affects mostly people older than 50.  Smokers and people with diabetes, obesity or a family history of coronary artery disease are especially susceptible to PVD. 

I caught up with doctors Bryan Piotrowski, MD, and Bryon Gorton, MD, who about the signs, symptoms and treatment options for PVD.

Dr. Piotrowski, interventional cardiologist on staff at Des Peres Hospital, explained that plaque, a substance made up of fat and cholesterol, builds up on the inside walls of the arteries and restricts normal blood flow. This buildup of plaque is called atherosclerosis, or hardening of the arteries.

“Atherosclerosis can affect arteries anywhere in the body,” said Dr. Piotrowski. “When it affects the arteries of the heart, it is called coronary artery disease and can cause a heart attack. When it affects the arteries supplying the brain, it is called carotid artery disease and can lead to a stroke.”

Atherosclerosis in the arteries that supply blood to the kidneys, stomach, arms, legs or feet is called peripheral arterial disease (PAD). One in every 20 Americans over the age of 50 has PAD. Prevalence of the disease increases with age and affects a disproportionate number of African-Americans.

Risk factors for developing PAD include smoking, diabetes, age, being overweight, and elevated blood pressure and cholesterol levels. Smoking is more likely than any of the other risk factors to cause PAD. In fact, a smoker’s risk can be up to four times higher than a non-smoker’s.

If you have PAD you are more likely to develop other forms of cardiovascular disease. Compared to the rest of the population, a person with PAD increases your risk of coronary artery disease, heart attack, stroke or mini stroke.

One of the first signs of PAD can be painful cramping or fatigue in the legs and buttocks that occurs during activity, but stops during rest. However, approximately half of people with the disease have mild or no symptoms.

“PAD also can cause leg numbness or weakness, cold legs or feet, skin color changes in the arms or legs, toe or foot sores that don’t heal quickly, hair loss on feet and legs, and burning or achy feet and toes when resting or lying down,” said Bryon Gorton, MD, medical director of the Wound Care Center by Des Peres Hospital.  “In advanced stages, blood flow to a leg or foot can be severely blocked, causing tissue death that may result in amputation.”

Diagnosing PAD can be done through an ankle-brachial index test which compares blood pressure levels in the ankle and arm. Angiography, 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. A medical history, physical exam or ultrasound also may be used to diagnose PAD.

People diagnosed with PAD can usually be treated with lifestyle changes, medications or a combination of both. Lifestyle changes include smoking cessation, diabetes management, blood pressure control, exercise and a healthy diet. Medications may be prescribed to lower cholesterol or blood pressure, control blood sugar (for diabetics), prevent blood clots or relieve certain symptoms. In some cases, however, surgery may be necessary to open vessels using a balloon catheter (a small, hollow tube). Doctors may bypass the blocked vessel using either a graft or directly inject a clot-dissolving drug into the artery. In some cases, a stent (a mesh tube) is inserted to keep the vessel open.

Leg pain, numbness or other symptoms should not be dismissed as normal aches and pains of aging. Early diagnosis and treatment of PAD is important to not only protect your health, but also decrease your risk of heart attack or stroke.

To find out more about PAD, join us for a free seminar on Wednesday, September 25 at 6:30 at Des Peres Hospital.  Call 1-888-457-5203 for more information.