What is peripheral arterial disease or PAD? How is it diagnosed and treated?
The correct answer and explanation is:
What is Peripheral Arterial Disease (PAD)?
Peripheral Arterial Disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs, most often the legs. This happens due to atherosclerosis, a condition where fatty deposits (plaques) build up on the artery walls, causing them to harden and narrow. Reduced blood flow can lead to symptoms such as leg pain when walking (claudication), numbness, weakness, or in severe cases, ulcers or gangrene.
Diagnosis of PAD
- Medical History and Physical Exam: The doctor asks about symptoms, risk factors (like smoking, diabetes, high blood pressure), and checks pulses in the legs and feet.
- Ankle-Brachial Index (ABI): This is a simple, non-invasive test that compares blood pressure in the ankle with blood pressure in the arm. A lower blood pressure in the ankle suggests blocked arteries.
- Ultrasound/Doppler Studies: These imaging tests evaluate blood flow and can pinpoint the location of blockages.
- Angiography: If further detail is needed, a dye is injected, and X-rays or CT/MRI scans visualize blood flow in arteries.
Treatment of PAD
- Lifestyle Changes: The first step includes quitting smoking, exercising regularly (walking programs), and managing risk factors like diabetes, cholesterol, and blood pressure.
- Medications: Drugs can help improve symptoms and reduce the risk of complications. These include:
- Antiplatelet agents (e.g., aspirin) to prevent clots.
- Cholesterol-lowering medications (statins).
- Medications to improve walking distance (e.g., cilostazol).
- Procedures: For severe PAD or when lifestyle and medications don’t control symptoms:
- Angioplasty and Stenting: Minimally invasive procedures to open narrowed arteries.
- Bypass Surgery: Creating a detour around blocked arteries using vessels from another part of the body.
Summary
Peripheral Arterial Disease is a condition caused by narrowed arteries reducing blood flow to the legs, often leading to pain and mobility issues. Diagnosis involves physical exams and tests like the Ankle-Brachial Index and imaging studies. Treatment focuses on lifestyle changes, medication to control symptoms and prevent complications, and sometimes surgical interventions to restore blood flow. Early diagnosis and management are essential to prevent serious outcomes like limb loss.