SPRINGFIELD – Not all vascular problems such as peripheral artery disease (PAD) have life-saving symptoms. Some vascular diseases, like carotid artery disease, can be quite silent and deadly.
As part of American Heart Month in February, vascular surgeon Dr. Marc Norris from the Heart & Vascular Program at Baystate Medical Center, is focusing his efforts on increasing public awareness about the many peripheral vascular problems associated with coronary artery disease.
Vascular disease includes any condition that affects your circulatory system – ranging from diseases of the arteries, veins and lymph vessels, to blood disorders that affect circulation.
In peripheral artery disease, the same fat or "plaque" buildup that causes coronary artery disease occurs in arteries and veins which supply blood to other parts of the body. Most often PAD affects the arteries in your legs, but can also involve blockages in the intestinal and kidney arteries.
Peripheral artery disease increases your risk of coronary heart disease, heart attack, and stroke. Also, persons with heart disease have a one in three chance of developing blocked arteries in their legs, resulting in numbness or leg pain, especially when climbing stairs or walking or with more vigorous activity, Norris noted.
Other symptoms could include sores or wounds which are slow to heal, especially on the feet, which is often a major problem for those whose diabetes is also out of control.
"Risk factor modification is very important in the treatment of peripheral artery disease. If someone smokes or has high blood pressure, high cholesterol or diabetes, those diseases must be brought under control, along with a program to stop smoking," Norris said.
"We may also prescribe medications to address leg pain and possible blood clots that can result because of the decreased blood flow. And, it's important, despite the pain, to continue some sort of exercise such as walking, cycling or water aerobics to really work the muscle groups in the legs," he added.
Other treatments could involve surgery or procedures to help open the arterial blockage such as angioplasty, bypass grafting, and atherectomy to remove the plaque buildup.
People with blockages of the arteries leading to the kidney may have difficulty keeping their blood pressure under control and kidney failure can result. Your primary care doctor may suspect this problem if you have peripheral arterial disease and trouble with high blood pressure, Norris noted.
Those with intestinal arterial blockages can have pain after eating and weight loss. This can sometimes mimic other intestinal problems such as peptic ulcer disease. Each of these problems, if suspected, can be tested for by using noninvasive ultrasound.
Carotid artery disease, also referred to as carotid stenosis, involves the two large blood vessels in the neck which carry important blood to the brain. The common vascular disease occurs when the arteries become narrowed because of the buildup of plaque inside the artery walls – known as atherosclerosis – resulting in the possible formation of a blood clot which can cause a debilitating stroke.
"Because most patients experience no symptoms with carotid artery disease, doctors must be vigilant in testing those patients at risk," said Norris, who noted risk factors are similar to those for PAD, including high blood pressure, high cholesterol, smoking, diabetes, alcohol abuse, and a family history of stroke.
He said a simple non-invasive ultrasound, often conducted in the office, can determine a possible blockage.
"Surgery, which we refer to as carotid endarterectomy, is most often the first line of defense to remove the plaque buildup with the goal of preventing future strokes. For those who can't have surgery, angioplasty, where we place a stent in the artery to open it up, is another option. However, there is a greater risk of causing a stroke with the angioplasty," Norris said.
Also, for those with less severe narrowing, blood thinners may be prescribed to lower the risk of stroke.
"The good news is that similar to heart disease, if your other illnesses like high cholesterol, high blood pressure, or diabetes are brought under control, and you refrain from bad habits such as not exercising or eating foods high in fat or sugar, then most patients with vascular disease will do quite well with only the use of medications," Norris said.
To learn more about the Heart & Vascular Program at Baystate Medical Center, visit baystatehealth.org/bhvp