Health Encyclopedia

Peripheral artery disease

Definition

Peripheral artery disease is a problem with blood flow in the arteries, usually the legs. Poor circulation and blockage of blood in the leg arteries produces an aching, tired, and sometimes burning pain in the legs. This pain is brought on by exercise, and relieved by rest. The limping that occurs from the leg pain is called claudication.

Alternative Names

Blockage of leg arteries; Claudication; Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of the legs; Recurrent leg pain and cramping; Calf pain with exercise

Considerations

This condition may occur in both legs, and the symptoms often get worse over time. However, some people complain only of weakness in the legs when walking, or a feeling of "tiredness" in the buttocks. Impotence is an occasional complaint in men. Pain at rest is uncommon.

Common Causes

This condition is due to atherosclerosis or peripheral vascular disease. Narrowed or blocked arteries can occur anywhere in the body. If they occur in the heart, a person may have heart pain (angina) or even a heart attack. If arteries are blocked or narrowed in the neck or the brain, a person may have a stroke.

Intermittent claudication is when the blockage occurs in the legs, most commonly in the calf or the foot. It occurs only at certain times, such as after a period of walking, and is relieved by rest.

Atherosclerosis can occur for many reasons such as smoking, diabetes, and high cholesterol.

Home Care

Talk to your doctor about the cause of your leg cramping and about what to do at home to relieve it. A healthy diet is important to keep atherosclerosis from getting worse.

A program of daily walking for short periods, and stopping for pain or cramping, may help improve function. You MUST stop smoking.

Avoid placing hot or cold items on legs. Avoid tight shoes.

Have your doctor check any non-healing wounds on the lower legs and feet.

Call your health care provider if

There are many other causes of leg pain such as arthritis or low blood potassium. However, some causes of leg pain may be life-threatening such a blood clot in the legs. Seek medical attention if you have:

Leg pain that does not go away
Legs that are red, hot or swollen
Chest pain or shortness of breath with leg pain
Diabetes
If you are pregnant

What to expect at your health care provider's office

Your health care provider will perform a physical examination and ask questions about your cramping leg pain and other symptoms, such as:

Do you have leg cramps at night?
How often does leg pain with cramping occur?
Is it getting worse?
Is the pain sharp?
Is there an aching pain with the cramps?
Is it worse after you exercise?
Is it worse after you are standing?
Do you smoke? How much?
Do you drink alcohol? How much?
Are you diabetic? How well is your blood sugar controlled?
What other symptoms are also present?
Has there been impotence (men)?
Is there pain in the back?
Is there a darkening of the skin of the legs, feet, or toes?
Is there weakness or paralysis of the legs?

The provider may check the pulse in the groin and other areas where the pulse can be felt in the legs.

The following tests may be performed:

Blood pressure measured in arms and legs for comparison
Doppler ultrasonography on the legs and the heart
Duplex Doppler/ultrasound exam of extremity to see how blood flows through arteries
ECG to check the activity of your heart
Aortography to see blockages in your large arteries

Surgery or angioplasty may be recommended if claudication interferes with the patient's activities or work, and if the diseased arteries are likely to improve after corrective treatment.

Review Date:7/25/2007
Reviewed By:Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.

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