Peripheral artery disease, or PAD, affects millions of Americans, many of whom are not aware of it. It is a common cardiovascular circulatory problem. When symptoms do appear, they often are in the form of extreme leg pain that can lead to gangrene, limb loss and even death.
There are new ways to test for this disease, including the QuantaFlo™ System. QuantaFlo™ is designed to help doctors accurately diagnose PAD quickly and efficiently. The earlier the diagnosis can be made, the sooner appropriate treatment can begin.
Understanding Peripheral Artery Disease
Peripheral Artery Disease (PAD) is a common circulatory problem of the cardiovascular system wherein the arteries narrow down to an extent where they cannot supply enough blood to the limbs. As a result of the constricted blood flow, the extremities, especially legs, do not receive an adequate supply of oxygen-enriched blood leading to notable pain while walking – a condition medically called intermittent claudication. The pain may disappear during rest.
Observations reveal that PAD is commonly caused by blockage of the arteries due to the accumulation of fatty deposits or plaques, a condition medically termed as atherosclerosis. The condition may affect arteries running throughout the body. When the condition blocks the arteries supplying blood to the limbs, that is PAD.
Certain risk factors and lifestyle habits may increase the chances of developing PAD. These factors include smoking, diabetes, high blood pressure, high cholesterol, cardiac ischemia, obesity, increasing age specifically reaching after 50, a family history of heart disease, stroke, or PAD, and higher levels of homocysteine, the protein component responsible for building and maintaining tissues.
A person suffering from PAD may show numerous symptoms indicating the presence of the complication. However, the person may not necessarily experience all or any of them. Studies reveal that many patients suffering from PAD do not even realize that they have PAD, due to lack of symptoms.
Common PAD symptoms include:
- Severe, compressive pain in the foot, calf, or buttocks during exercise, climbing up a staircase, running, or walking
- Feeling of numbness or weakness in the legs
- Muscular ache or cramps in the legs while walking
- Loss of balance while standing
- Brittle toenails that grow very slowly
- Loss of hairs on the legs and feet
- Cold sensations in the lower foot or leg
- Slow healing of ulcers and wounds on legs and feet
- Pale or shiny appearance of the skin on the legs
- Difficulty in locating the pulse in the foot or leg
- Erectile dysfunction in men
Some of the symptoms may even relate to other conditions. For this reason, a person experiencing some of these symptoms may not relate it to the peripheral artery disease. However, it is advisable to visit the doctor at the earliest to seek medical assistance and advice to ensure a firm diagnosis in case any of these symptoms are observed in a person.
PAD caused by plaque build up in the blood vessels increases the risk of developing:
- Stroke and heart attack – Atherosclerosis causing the signs and symptoms of PAD does not limit its effects to the legs or limbs. Fat deposits may build up further in the arteries supplying blood to the heart and brain thereby increasing the chances for heart attacks, strokes, hospitalization, and even death. A 2010 survey by Harris Interactive found that heart disease and stroke were two of the top five diseases feared most by Americans.
- Critical limb ischemia – PAD may lead to a critical condition called ischemia wherein open sores show up in the limbs that do not heal. Additionally, the patient may experience strong pain running from the thigh all the way down to the fingertips, even when at rest. The sores may occur as a result of an injury or infection in the legs or feet. These injuries or infections can cause the death of tissue (or gangrene). The condition may require amputation of the affected limb.
When To Visit A Doctor
If a person experiences continuous pain, numbness, or any other symptoms in the legs, the person must not ignore those symptoms as a part of ageing. The patient should call a doctor for a diagnosis.
Even when a person does not show up any symptoms of PAD, it is advisable to get screened for the disease in case the person is:
- Above 70 years
- Above 50 years with a history of smoking or diabetes
- Under 50 years of age with risk factors that may lead to PAD such as diabetes, obesity, or high blood pressure
Any health professional including a vascular surgeon, cardiologist, internal medicine doctor or even family medicine doctor can provide a diagnosis as well as treatment of PAD.
Diagnosis And Tests
Traditionally, PAD is diagnosed by a thorough questionnaire with the patient along with a physical examination. The questionnaire helps specialists to assess the patient’s risk factors, lifestyle habits that may cause PAD, as well as other primary aspects of the patient’s health. Patients must report any symptoms to their doctor. Further, the doctor examines the patient’s legs. However, a doctor heavily relies on the symptoms experienced by a patient.
Additionally, a doctor may conduct a specialized test to diagnose PAD and determine the absence or presence of any blockages. This specialized test measures the arterial pressure in the hands and feet to examine the ankle brachial pressure index or ABI. The doctor will also check the blood cholesterol levels of the patient to examine the condition of the cardiovascular system. However, these tests can be deterring and expensive.
Diagnosis of PAD often involves the analysis of instrumental studies which include ultrasound duplex scanning of the arteries connecting the extremities. This analysis helps the doctor to assess the structure as well as blood flow in the extremities. Doppler sensors and blood pressure cuffs are used by the doctor to determine the amount of blood flowing through various veins in the legs using high-frequency sound waves. The test helps diagnose narrowed blood vessels, areas with backward blood flow, as well as blood clots. Other tests recommended by the doctor include angiography with X-rays or Magnetic Resonance Angiography (MRA).
Ankle-brachial index test is used to compare the blood pressure in the arms and the ankle. Blood pressure cuffs placed on the arms and ankle are inflated and as the cuffs deflate, an ultrasound device records blood flow in both areas by using high-frequency sound waves.
Another popular test that is gaining momentum amongst clinics and practices for diagnosis of PAD is the QuantaFlo™ System from Semler Scientific which uses a digital sensor placed on the fingers and toes to record blood flow measurement. This system can check for PAD in less than five minutes. This latest technology test can assist the doctor to identify and diagnose PAD before the appearance of symptoms. The QuantaFlo™ System is a convenient, easy, fast, and portable test to diagnose PAD. The results are immediately available to the physician, who can initiate further treatment as appropriate.
The treatment procedure for PAD may involve regular exercise, lifestyle changes such as smoking cessation, medication, or even surgery depending on the severity of the condition. Initial steps may typically involve lifestyle modifications. Maintaining optimum levels of physical activity is paramount to get the best results from any treatment. Physical exercise serves as an initial treatment to cure intermittent claudication.
Patients can also perform other exercises to maintain muscle tone. There is a range of exercises for muscle toning that aims to increase muscular strength and increase the blood flow throughout the arteries.
Certain medications may also help treat PAD along with lifestyle modifications. Medication includes lipid-lowering and cholesterol decreasing drugs, as well as medication for treating high blood pressure. Antiplatelet drugs such as low dose aspirin may also be prescribed as a prophylaxis for preventing the occurrence of blood clots.
When more conservative treatments do not help, the disease may be treated surgically. Procedures such as angioplasty and stenting can be performed to restore and normalize the size of the blood vessels. The procedure may also include endarterectomy in which atherosclerotic plaque is removed. Certain advanced cases may require amputation of the affected limb in case of gangrene.
Here are certain lifestyle modifications to ensure a better cardiovascular system and healthy arteries:
- Regular Exercising – As stated earlier, optimum levels of physical activity are necessary for effectively treating PAD. Engaging in morning workouts or regular exercising routine provide the necessary mobility to the muscles of the limbs and ensure an improved blood flow. It also helps in controlling blood pressure levels and weight loss.
- Cautious Eating – Patients are advised to have low-carb meals having lower levels of fats and sugars to ensure lower levels of cholesterol and blood sugar. The patients having higher-levels of cholesterol and blood sugar are more prone to developing PAD. Healthy eating habits keep cholesterol and blood sugar levels in check and minimize the risks of developing PAD. For patients suffering from PAD, doctors recommend healthy meal plans to restore optimum cholesterol and blood sugar levels.
- Massage – Although it may not have a direct link with PAD, messaging help in increasing the blood circulation in the muscles of the limbs. Improved blood circulation often helps in treating symptoms of PAD and provides a sense of relief to the aching limbs. A message also heals numbness and weakness in the legs.
- Regular Medical Check-Up – Even when a patient shows signs of recovery, the patient must maintain regular medical check-ups to keep a check on the symptoms that may lead to PAD. An early detection of the symptoms and signs of PAD improve the chances of recovery and effective treatment. Routine check-ups involve a diagnosis of blood pressure, cholesterol, and blood sugar. It is advisable to keep a check on these parameters to avoid unexpected health challenges.
- Managing Risk Factors – Risk factors such as smoking, diabetes, high cholesterol, and high blood pressure can be controlled by through medications and lifestyle changes such as increasing exercise and avoiding cigarette smoking, high sugar intake, and fatty foods.
PAD may lead to limb loss, stroke or heart attack if not properly diagnosed. Therefore, early detection is highly recommended. The QuantaFlo™ System by Semler Scientific is a fast, simple and cost-effective diagnostic test that assists medical professionals in the early identification of PAD.
Traditionally, the Ankle-Brachial Index Test (ABI), has been used to diagnose PAD. The QuantaFlo System is a more convenient approach for PAD testing. Unlike ABI testing which requires a specially-trained medical technician to perform, the QuantaFlo test can be performed by any medical aid, nurse of physician. No special training is required.
A large number of Americans suffer from PAD yet the disease is often not diagnosed during its natural course until later in its course, thereby leading to stroke, heart disease or limb amputation. The QuantaFlo system serves as a ray of hope for patients who can now get an early diagnosis simply and painlessly in the doctor’s office.
PAD is a comorbid condition that does not occur by itself. It is a condition present in case of the existence of other forms of cardiovascular disease. While exercising paired with appropriate diet helps keep a check on cholesterol and blood sugar levels, an early identification of PAD and modification in lifestyle help in obviating the requirement for medical or procedural intervention. In fact, if the patient does require procedural intervention, starting early helps in treating the condition more effectively.
The QuantaFlo System is intended for the early detection of PAD. The QuantaFlo software can be easily installed on any Window-based laptop, PC, or tablet and is used in conjunction with a proprietary QuantaFlo sensor that is attached to the patient’s fingers and toes. It can be used in by medical professionals in healthcare centers, health fairs, community screening events, specialty practices, primary care offices, and during home assessments.