Heart and Vascular Health Leg Pain Could Warn of Vascular Problems By Heart and Vascular Institute, January 30, 2015 Leg pain while walking or climbing stairs may be a sign of a serious condition known as peripheral arterial disease, or PAD. Most people who suffer from PAD are unaware they have the disease. That is a major problem because untreated PAD can not only make walking difficult but may increase your risk of heart attack, stroke, gangrene, leg amputation, and even death. PAD occurs when plaque clogs leg arteries or vessels and restricts blood flow. Eventually, the restricted flow causes discomfort, called claudication, while walking or exercising. It’s important to be able to recognize the symptoms of PAD and visit your doctor to receive an early diagnosis. Proper treatment for this disease is extremely important and symptoms should not be ignored. Recognize the Warning Signs The most common symptom of PAD is pain in your leg muscles — not your joints — when you walk, climb stairs, or exercise, that goes away when you rest. Other symptoms Pain and/or cramping in legs and hips Numbness and tingling in the lower legs or feet Marked decrease in temperature of lower leg or foot, particularly compared to your other leg or the rest of your body Sores or wounds on toes, feet, or legs that heal slowly, poorly, or not at all Color changes of the skin of your feet, including paleness or blueness Poor nail growth and decreased hair growth on toes and legs Burning or aching in feet or toes while resting Leg weakness If you experience any kind of recurring leg pain, speak with your family doctor and describe the pain as accurately as you can. Identify the Problem While everyone knows how important it is to treat and prevent heart disease, most are not aware of the seriousness of PAD. If your leg arteries are clogged, it’s quite possible that other blood vessels around your heart and brain may be as well. People with PAD are more likely to die of a heart attack or stroke than people without PAD. Fortunately, PAD can be easily diagnosed, and effective treatment will significantly reduce or eliminate the risks of severe complications. The ankle-brachial index (ABI), a painless test in which blood pressure is measured in the legs and arms to determine how well your blood is flowing, is the most common test for PAD. When an ABI reveals an abnormal ratio between the two blood pressures, additional testing may be required. Depending on the results of the ABI, noninvasive imaging techniques, such as a CTA or MRA, may be used to determine the location of the blockage. Find the Solution Most PAD cases can be managed with lifestyle changes — smoking cessation, diet, a dedicated walking or exercise program, and/or medication. In some cases, other treatment may be necessary to open an artery. Some minimally invasive percutaneous treatments for PAD include: Angioplasty Stenting Cryoplasty and Atherectomy At times, patients need a surgical bypass procedure, which involves taking a vein from another part of the body or using a synthetic bypass graft to create a detour around the blocked artery. Sometimes a combination of procedures is appropriate. The decision on which treatment to use depends on the location and severity of the plaque, the condition of the arteries around the plaque, and the age and overall health of the patient. Are You at Risk? Those with the highest risk for developing PAD are people who: Are older than 50 Use tobacco Are diabetic Have high blood pressure Have high cholesterol Are overweight Are physically inactive Have a family history of PAD or other cardiovascular diseases The more risk factors that apply to you, the more important it is to talk with your family doctor, get screened for PAD, and reduce your risk for heart attack or stroke. If you think that you or a loved one may have PAD, visit the UPMC Heart and Vascular Institute and schedule an appointment to speak with an expert today.