Peripheral Vascular Disease/Peripheral Arterial Disease - Advanced Physical Medicine
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Peripheral Vascular Disease/Peripheral Arterial Disease

Poor circulation to the legs and feet is a very serious condition that has recently gained publicity.  PAD (peripheral arterial disease) or PVD (peripheral vascular disease) are common ways of referring to poor circulation or blood flow to the lower extremities (legs/feet).  There are two main arteries that supply the feet: posterior tibial artery and dorsalis pedis artery.  These two arteries are checked when you have a foot exam.

Poor blood flow means that there is either a blockage in one or several blood vessels or narrowing of the vessels so that blood does not flow easily through the vessels.  Sometimes, blood does not flow at all, if the vessels are completely blocked, and this is a very serious condition which often leads to limb loss.

Causes of PAD:  common causes of poor circulation include the following:  smoking, hypertension or high cholesterol, obesity, sedentary lifestyle, diabetes, and other chronic, serious conditions.

Signs of PAD:  pain, color changes to the toes, cramping after walking a certain distance, toenail changes, thinning of the skin of the feet, lack of hair growth to the feet, and in the worst case, pain with rest or sleeping that is only relieved with dangling the foot out of the bed or walking around.  Often, the pulses of the feet are weak or not present.

Testing for PAD:  circulation tests or arterial doppler exams are ordered to assess the blood flow of the legs and feet. This test uses blood pressure cuffs to monitor the blood flow, and the blood flow of the ankle is often compared to the blood flow or pressure in the arm to determine an ankle brachial index or ABI.  The waveforms created by these measurements and the number of the ankle brachial index or ABI determine if a person has poor circulation and whether they need to be referred to a vascular surgeon or interventional cardiologist for a more extensive work up.

Treatment:  often, podiatrists refer patients to other doctors for treatment of severe cases of PVD/PAD.  Early forms of the disease are often treated with medication, exercise, controlling blood pressure and cholesterol levels, controlling blood sugar levels, and cessation of smoking.  More serious disease may require surgery.

If you think you have poor circulation to your feet, please called Advanced Physical Medicine for an appointment with Dr. Bender, Oak Park and Chicago's premier foot and ankle specialist!

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