ARTERIAL DISEASE OVERVIEW

What is Peripheral Artery Disease (PAD)

Peripheral artery disease, or PAD, refers to arterial disease that occurs outside of the heart or brain. In PAD, the arteries that carry oxygenated blood throughout the body become narrowed or even blocked, usually as a result of atherosclerosis, or plaque in the arteries. PAD most commonly affects the arteries in the legs, but it also can involve arteries that carry blood to the head, arms, kidneys and gastrointestinal (GI) tract.

What are the symptoms?

Many people with PAD have mild or no symptoms; others experience occasional claudication, or leg pain when walking. The severity of intermittent claudication varies from mild to debilitating. Other PAD symptoms include sores or ulcers that don't heal and persistent coldness in the feet and lower legs.

Among the risk factors for PAD are diabetes, smoking, high cholesterol and high blood pressure. Most cases occur in people older than 50.

How is PAD diagnosed?

Several imaging tests can be used to diagnose PAD:

• Vascular ultrasound. This exam uses sound waves to create pictures of the arteries and locate blockages.

• Doppler ultrasound: Doppler ultrasound is a special ultrasound technique that can help detect areas of restricted blood flow through an artery.

• Catheter angiography: This minimally invasive imaging exam relies on a contrast agent and x-rays to show blood flow in the arteries in the legs and to pinpoint any blockages that may be present. The contrast agent is injected through a tube or catheter that is usually placed through a blood vessel in the groin.

• CT angiography (CTA): CT angiography uses a CT scanner to produce detailed views of the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.

If the condition is not severe, simple life changes can be made to slow PAD.

What is Claudication due to PAD?

Claudication is pain caused by too little blood flow, usually during exercise. Sometimes called intermittent claudication, this condition generally affects the blood vessels in the legs, but claudication can affect the arms, too.

At first, you'll probably notice the pain only when you're exercising, but as claudication worsens, the pain may affect you even when you're at rest. Claudication is not a disease itself, but is often a symptom of a disease called Peripheral Artery Disease, a potentially serious but treatable circulation problem in which the vessels that supply blood flow to your legs or arms are narrowed.

What is Kidney (Renal) Disease?

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

What is Pulmonary Disease?

Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by long-term breathing problems and poor airflow. The main symptoms include shortness of breath and cough with sputum production. COPD is a progressive disease, meaning it typically worsens over time. Eventually, everyday activities such as walking or getting dressed become difficult. Chronic bronchitis and emphysema are older terms used for different types of COPD. The term "chronic bronchitis" is still used to define a productive cough that is present for at least three months each year for two years.Those with such a cough are at a greater risk of developing COPD.

What is an Angiogram?

Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers. This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy. The image of the blood vessels is called an angiogram.