Atherosclerotic Vascular Disease

Atherosclerotic Vascular Disease affects nearly 10% of the population over the age of 65 years. It is noticed more commonly among men. Atherosclerotic vascular disease is probably one of the most common causes for death and disability.

Atherosclerotic peripheral vascular disease is a condition where there is a build-up of plaque in the arteries outside the heart. The thickened arteries constrict the flow of blood. This leads to inadequate supply of oxygen to all parts of the body. The mortality rate for this vascular disease is high and there is possibility of loss of limb too. Typically the limbs, kidneys and neck are affected. The symptoms of atherosclerotic peripheral vascular disease include numbness and tingling feeling in the limbs, sores that do not heal and dull, cramping pain in the hips or thighs. Claudication or pain in the lower extremity muscles is a common symptom. Smoking increases chances of peripheral atherosclerotic vascular disease. Other risk factors for atherosclerotic vascular disease are obesity, coronary heart disease and lack of exercise.

ABI (Ankle/Branchial Index) is a popular test that helps in detecting atherosclerotic vascular disease. Angiography is a special x-ray that helps in tracking artery blockages and narrowing. Ultrasonography and MRI aid the physician in non-invasive diagnosis of atherosclerotic vascular Disease. Simple tips to keep atherosclerotic vascular disease at bay:

• Maintain healthy weight
  
• Keep high blood pressure and high cholesterol under control
  
• Control diabetes

Angioplasty is used to enlarge blocked arteries without surgery. But it is not a permanent solution. Medications such as Pentoxifylline (Trental) and Cilostazol (Pletal) are used to treat atherosclerotic vascular disease. They help in reducing blood viscosity. Surgery is resorted to when the arteries are blocked considerably. Bypass surgeryis a surgical procedure whereby the affected artery is bypassed so that blood flow is restored.

Peripheral Vascular Disease

Peripheral Vascular Disease(PVD) or Peripheral artery disease (PAD) is a condition where the arteries supplying blood to the limbs and internal organs get blocked as a consequence of atherosclerosis. Fatty deposits get built up in the arteries and reduce the flow of blood to the organs being supplied by the peripheral arteries. Atherosclerosis is by far the leading cause for Peripheral Vascular Disease. Diabetes is a condition that puts a person at high risk for PVD. Smoking and obesity increases the risk for Peripheral Vascular Disease. Persons who are obese and suffer from hypertension are at higher risk for Peripheral Vascular Disease. A sedentary lifestyle without any exercise should be avoided.

Intermittent Claudication is noticed in patients suffering from Peripheral Vascular Disease. Symptoms associated with Peripheral Vascular Disease include numbness or tingling in the limbs, sores that do not heal and pain in the buttocks. A patient suffering from Peripheral Vascular Disease notices changes in skin color and temperature. There may be a dull and cramping pain in the calf, thigh and hip muscles. Ankle Brachial Index (ABI) involves a ratio of the blood pressure in your ankle to the pressure in your arm. Angiogram is a dye test that reveals any possible blockage in the arteries. Ultrasound Doppler Test uses imaging to check for plaque build-up in the arteries. Duplex ultrasound helps in accurate detection of the size of the artery stenosis and the extent of blockage.

Medication is prescribed to eliminate the narrowing of the arteries thereby improving the heart efficiency. Anti-platelet or anti-clotting agents such as cilostazol and pentoxifylline or aspirin and Clopidogrel help in improving blood supply to the extremities. Heparin and Warfarin are anticoagulant drugs that can prevent blood clotting. Blood viscosity is controlled to improve blood flow. Drugs to control hypertension and cholesterol may also be prescribed. Bypass surgery allows a new blood route that circumvents the blocked areas of the peripheral arteries. Endarterectomy is a surgical procedure whereby a surgeon cleans out plaque buildup inside the artery of the affected leg or arm. Cryoplasty, a newer form of Angioplasty uses liquid nitrous oxide to open a narrowed artery and destroy the plaque within. Regular supervised exercise can reduce symptoms of intermittent Claudication.

Microangiopathy

Microangiopathy affects small blood vessels and capillaries and leads to insufficient oxygen and nutrient distribution to tissues. Microangiopathy or micro vascular disease is usually a result of chronic hyperglycemia or diabetes. Hypertension and hyperlipidemia can also contribute. Microangiopathy can finally lead to diabetic retinopathy, diabetic foot and neuropathy.