Monday, March 12, 2012

Could Poor Circulation Indicate a Looming Heart Attack?


Do your feet and legs cramp when walking?  Do you have pain at night when laying down or when your feet are elevated?  If so, you may have a condition know as peripheral arterial disease.

Peripheral arterial disease, or PAD, is a condition where the arteries of the lower extremity become narrowed due to plaque build up and/or stenosis of the arteries. Plaque build up, or atherosclerosis, is when cholesterol and other substances in the blood cause debris to stick to the insides of the artery. Over time, this can narrow the artery, much like grime can narrow the plumbing in your home.

Symptoms of PAD include cramping upon activity in the calves, thighs, or feet. This pain is usually reproducible with a certain distance, and is relieved with rest. Other signs of PAD may include hair loss in the feet and legs, coldness in the toes, color changes in the feet with a change in position, and absence or weakness of pulses on physical exam.  Sometimes people with peripheral arterial disease will say something about having “bad circulation”. 

Left untreated, peripheral arterial disease will get progressively worse as the arteries continue to narrow.  Pain can increase in frequency, and the distance that a person will be able to walk without pain will decrease.  Poor circulation in the feet can also lead to poor wound healing and areas of gangrene development in the toes.

Risk factors for peripheral arterial disease include smoking, obesity, high blood pressure, high cholesterol, and diabetes. Advanced age can also contribute to the development of PAD, as well as inactivity.

The diagnosis of PAD is made through a detailed history and physical exam, which should include checking pulses to the feet and inspection for other signs.  Often non-invasive vascular testing is ordered in the clinical setting.  This involves putting blood pressure cuffs up and down the legs at different levels and measuring the pressure difference through the leg.  This can help isolate the area of disease.  The amount of oxygen reaching the toes can also be measured clinically, which can also help monitor the disease. 

For patients with peripheral arterial disease, screening for plaque build up in all parts of the body is essential. Atherosclerosis is a systemic disease, and the coronary arteries supplying the heart and carotid arteries supplying the brain can also show signs of disease. Unaddressed, this build-up can lead to heart attack or stroke.

It is for this reason that it is incredibly important for patients with risk factors to be screened for PAD.  The risk of heart attack and stroke associated with peripheral arterial disease has been well documented.



Central Florida Foot & Ankle Center, LLC 
101 6th Street N.W. 
Winter Haven, FL 33881 
Phone: 863-299-4551 
www.FLFootandAnkle.com