Peripheral arterial disease


Peripheral arterial disease

Description of peripheral arterial disease

Peripheral arterial disease, is a disease affecting the arteries.This disease never occurs in veins. Its occurrence is more frequent in advanced age.

Artery lumen narrows and may occur up to their gradual closure.The consequence of this process, ischemia or blood supply,which means that the limb, which is located below the arterial occlusions, ceases to be supplied with a sufficient amount of blood, and thereby the necessary nutrients and oxygen.

 

Causes of peripheral arterial disease

Cause of the disease and thus occlusion or narrowing of the arteries, is few. These include atherosclerosis, thrombus (blood clot), Buerger’s disease or vasoconstriction (narrowing) of arteries, based on a nerve disorder that affects the affected blood vessel.

Nowadays, the most common cause of atherosclerosis, formerly known as hardening of the arteries. Atherosclerosis has long been an ongoing disease, which is caused mainly by depositing substances of fat character (atherogenic) in the artery wall. At the point where the fatty substances are stored, there is a narrowing of the lumen of the artery and blood can not sufficiently flow into the other part.

Buerger’s disease is an inflammatory vascular disease, which manifests itself with chronic limb occlusion. The incidence of this cause, but is now rapidly declining.

 

Signs and symptoms of peripheral arterial disease

This disease has a variety of manifestations, depending on the stage and location of the narrowing (stenosis) or cap (obliteration).

The most known breakdown, according to stage of the disease within four phases. The first phaseis called the latency stage, the patient does not experience any difficulty, but the affected extremity and particularly its edge portion tends to be cold, especially when the surrounding temperature of the environment is low. If the examination was performed arteries of the lower limb, it would be revealed even at this stage beginning constriction.

Later, in the second stage of the disease appears typical symptom is intermittent claudicationthereby -přerušované lameness. Exertional lower limbs, mostly on foot, there is severe pain in the affected limb, which forces the patient to limp or stop. If the patient stops and rest, the pain subsides and he can continue walking.

Pain following trouble occurs because the muscles during activity need more oxygen, which brings them blood, but due to arterial constriction, they can not blood flow in sufficient quantities to satisfy the need for muscle.

If the disease continues to deteriorate, the pain occurs when you walk for shorter distances (after 200-300 meters) and significantly impairs patient quality of life. It can be said that the shorter the distance that a disabled person unable to walk without pain felt at that, the worse the condition of the arteries.

At this stage, you may already emerge trophic changes (dry skin, hair loss, muscle weakness, slow growth and fragility of nails).

The third phase is the permanent limb pain, occurs during the day, but often the patient has major problems at night when it wakes from sleep. Relief will then arrive at a marmot limbs. It is therefore not uncommon for the patient sleeps with a leg running out of bed or even prefer spending the night in a chair.

In the final, fourth phase is the status of blood flow to the limb has been critical, there are muscle twitches and spasms. The patient is threatened gangrene (tissue necrosis), which first appears on the periphery, thus fingers.

Every, even small, wounds on the affected leg is a serious threat due to poor blood circulation because the wounds heal and thus creating large defects. Unfortunately, this phase can often resulting in amputations.

Furthermore, speeches can be divided, depending on what part of the artery is narrowed or cap. If you feel sick sore feet, they are likely to be affected arteries of the leg. It occurs when the calf pain, it is probably a violation of the flow in the knee or the thigh arteries. Thigh pain suggest impairment of deep femoral artery. Pain in the buttocks caused disability large artery in the hip area.

 

Risk factors for peripheral arterial disease

Since the disease occurs most frequently on the basis of atherosclerosis risk factors they are essentially identical. The main risk is smoking. For smokers than non-smokers probability of 100: 1st

Other risks are lack of exercise, increasing age, mental stress, obesity and hypertension, or high blood pressure (above 140/90 mm Hg in patients with diabetes over 130/80 mmHg).

The emergence is also involved in increased blood cholesterol levels and metabolism of fats and sugars. This condition often occurs as a complication associated with diabetes (diabetes).

Most of these factors contributes to damaging the artery wall, which causes the formation of constriction or closure.

 

Prevention of peripheral arterial disease

Preventing the disease involves the removal of risk factors.

So it is important to have a proper diet. This means not smoking, eating a healthy balanced diet, especially avoiding foods high in animal fat.

It is also important physical activity.

If you have diabetes (diabetes) or high blood pressure, follow treatment by the medical doctor.

 

Treatment of peripheral arterial disease

Crucial for the proper election therapy, diagnosis and the stage at which the patient is located. The doctor has a patient to determine a wide range of information.

The important thing for him is when he first appeared limb pain in which limb is located, how long the patient harassed, if present only during exertion or when it is present even at rest and possibly how far the patient could walk without difficulties have arisen.

Furthermore, the doctor needs to know if the patient does not suffer from any of the diseases, such as hypertension or diabetes or whether the there occur some of other risk factors.

After a thorough medical history, it is necessary to perform a series of simple tests first. The doctor examines both legs. Notes, color temperature, determines whether it is not evident trophic changes (see. Above), palpation and auscultation checks the pulse in arteries of the legs.

The basic, but already demanding tests that your doctor may ask are: Doppler ultrasound test,color duplex sonography and arteriography.

If the doctor determines that it is not, a critical state, will start along with other experts, comprehensive treatment. The aim of this treatment is to remove arterial occlusion or narrowing.

The first step is called polochirurgické solution. Percutaneous transluminal angioplasty (PTCA).

Another approach is pharmacological, which is administering a vasodilator therapy (vasodilators – drugs expanding arteries) mostly in the form of infusion.

On the dilation of blood vessels having a positive impact muscular work, it is appropriate to moderate exercise lower limbs.

The third method is the design of the prosthesis.

The following therapy is an important treatment regimen and elimination of risk factors.

When, rarely, disease in a critical stage, the patient at risk of amputation of the affected limb.

In the introduction we have been described rare causes of this disease, such as vasoconstriction .: vessels. This cause is solved by removing some of the nerves that supply the limb.

If the problem is bound to a blood clot, performs his removal (embolectomy) and the subsequent anticoagulation therapy (treatment to prevent blood clotting).

 

How can I help myself

If you have been diagnosed with the disease or, if you have some of his symptoms, then it is essential that the treatment led expert.

But a few things that the patient can contribute to the treatment itself. Firstly, it is important not to smoke. If you are a heavy smoker, and not to quit the habit, at least try to minimize.

The kitchen is recommended, instead of animal fats, use vegetable.

If it is at all possible, avoid stressful situations and learn how to relax, preferably with some physical activity. The ideal is enough movement in the form of swimming, cycling or brisk walking at least 4 times a week for 30 minutes. Your body mass index – BMI – should be in the range of 18.5 to 25.0.

Be careful to avoid injury to the affected limb. Do not go barefoot. Wear comfortable, airy shoes that do not press, preferably with a covered heel and toe. Choose socks bright colors, with a rubber band, which avoids stiffness. Pay your feet enough and gentle hygienic care, after-bath is thoroughly dry, to prevent them from evaporating.

Be especially careful when cutting nails. If you go to a nail professionals prefer to always advance report that suffer from this disease. For each, albeit small, injuries to the leg, tell your doctor.

Never leave prochladnout limb.

 

Complications of peripheral arterial disease

Complications of the disease lie mainly in the form of injury to the affected limb. This creates namely defects that are a result of poor blood circulation in the legs can not heal properly and become one large wound. This can lead to tissue breakdown and secondary sepsis (poisoning organism) the infected defect.

Other names: PAD, coronary artery disease, the arteries of the lower extremities, chronic limb occlusion, ischemia arteries of the legs, cold feet

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