Peripheral Artery Disease and Leg Pain in Waco, TX
Leg pain that often occur when walking is often regarded as being the result of arthritis, deterioration from age-related issues, or being tired. However, if leg pain occurs consistently with physical activity and subsides once at rest, it typically indicates there is a problem with circulation. Many individuals searching the internet for the symptoms of peripheral artery disease are experiencing these symptoms, but few link them to a vascular problem. At Waco Heart &Vascular, our cardiologists look at peripheral artery disease (PAD) in conjunction with a larger picture of cardiovascular problems.
Why Poor Circulation Causes Leg Pain During Activity
How Reduced Blood Flow to Leg Muscles Causes Pain While Walking
Your body uses more oxygen as you walk and relies on healthy arteries to accommodate increased blood flow. However, when the arteries that supply blood and oxygen are narrowed, as is the case with patients with PAD, they cannot provide adequate amounts of blood and oxygen to the muscle. The result is an accumulation of metabolic waste products in the muscle, resulting in tightness or cramping of the muscle.
The exact location of the cramp is an important factor for cardiologists to evaluate, as it may indicate the location of the blockage in the arterial system (for example, calf cramps typically indicate disease in the arterial supply from the thigh). High locations of cramps may indicate central vascular narrowing.
Why Symptoms Often Improve After Rest (Intermittent Claudication)
The reason why pain gets better with rest is fairly straightforward. The muscles require less oxygen when they are not moving. As the demand decreases, the amount of blood available to the muscles also becomes sufficient once again, resulting in the pain diminishing in a matter of minutes. Many patients may think that this means the issue is trivial; but it’s not. Clinically, this pain pattern is one of the strongest signs of PAD.
Unlike muscle strain, which will continue to be painful or worsen afterwards, PAD pain has an extremely consistent cycle of on and off periods when it occurs. This reliability is typically what leads cardiologists to prioritize vascular testing earlier on in the patient’s course of treatment.
How Artery Narrowing Limits Oxygen Supply to the Muscles
Patients with PAD have arteries that are not only narrowed, but also stiff and inflexible. Even if the narrowing is only moderate, the artery will be unable to expand to allow for adequate blood flow when activities require increased oxygen due to activity or exercise. Therefore, symptoms are initially only noticed when engaging in activities such as walking or climbing stairs.
When evaluating symptoms at Waco Heart and Vascular, we consider a patient’s level of activity, as an active patient will likely notice symptoms before a more sedentary person will. This helps to illustrate why two individuals who have similar arterial blockages can have widely different symptom experiences.
Symptoms of Peripheral Artery Disease When They Suspect Circulation Problems
Symptoms of Peripheral Artery Disease When They Suspect Circulation Problems
Leg Pain, Cramping, or Tightness While Walking or Climbing Stairs
In most cases, patients having PAD symptoms will not report the pain associated with their condition as acute (sharp/stabbing). Rather, they’ll typically describe it as a feeling of being ‘tight’ or ‘cramped’ through the muscle (especially in the legs), to the point of requiring them to stop walking.
A key clinical indicator of PAD is that the patient has consistent symptoms (e.g., painful feeling begins at the same distance each time the patient walks), which indicates that there may be a problem with circulation. This consistency also helps clinicians differentiate between PAD and other types of joint disorders, which often present differently from day to day, and can also be helpful for evaluating the extent of the problem.
Cold Feet, Numbness, or Weakness in the Legs
Cold toes are often fairly common, but should not have discrepancies between them. If one foot is colder than the other, the healthcare provider usually examines both feet to identify any differences in temperature and coloration. Numbness and weakness, along with cold feet, may indicate a lack of blood flow regardless of whether there are other symptoms present (numbness, weakness).
In Waco, TX, many patients notice these signs and symptoms and begin to worry about poor blood circulation in their feet without knowing that PAD could be the cause of those symptoms. Early detection of these signs of poor circulation in the legs would allow cardiologists to provide treatment before they develop into more critical conditions.
Slow-Healing Wounds or Color Changes in the Lower Legs and Feet
The presence of a slow-healing wound is often the earliest indication that an individual has advanced PAD, or decreased blood flow getting to the legs and feet, which is causing tissue damage due to lack of blood flow, oxygen, and nutrients.
Wound care and vascular treatment work together to promote healing of these wounds by restoring blood flow to the affected area. In many cases, patients with diabetes are especially vulnerable because they may not be able to feel their injuries due to damage to their nerves. Changes in the color of the skin, including pale (whitish) or blue (cyanotic), can also indicate decreased blood flow and should not be ignored.
How Peripheral Artery Disease Develops in the Body
How Plaque Buildup Narrows the Arteries Supplying Blood to the Legs
PAD develops over time due to the accumulation of plaque in the inner linings of the arteries. The plaque consists of cholesterol, calcium, and inflammatory cells.
Most individuals don’t notice symptoms until some degree of occlusion has occurred. For this reason, it may seem like PAD has appeared suddenly. Symptoms usually develop only after the patient has had Peripheral Artery Disease for a long period of time. Therefore, early PAD screening is important for detecting PAD in high-risk patients.
The Connection Between Atherosclerosis and Circulation Problems
PAD is an example of a larger medical condition called atherosclerosis, which causes diseases of the arteries throughout the body. The process that causes narrowing of the arteries in the legs can also lead to reduced blood flow to the heart and brain. Hence, it’s common for patients who have been evaluated for symptoms of PAD to be screened for other cardiovascular conditions.
Treating PAD without treating the risk factors that cause the disease as a whole will miss providing complete care. Cardiologists, when providing care for patients with PAD, place emphasis on reducing overall risk for the vascular system as opposed to providing relief of symptoms limited to the legs alone.
Why Peripheral Artery Disease Often Occurs Alongside Heart Disease
It’s common for people with peripheral artery disease to have both Peripheral Artery Disease and heart disease because the two diseases have the same cause — atherosclerosis. This is where a buildup of plaque, caused primarily by cholesterol, calcium, and inflammatory cells, forms inside arteries throughout the body.
Multiple risk factors exist, such as smoking cigarettes, diabetes, very high blood pressure, and very high cholesterol, that cause damage to blood vessels throughout the body. Essentially, these risk factors can damage the arteries in the heart, legs, and brain, all at the same time.
An additional problem is that inflammation and endothelial dysfunction cause the buildup of plaque in multiple arteries more quickly than normal, which is why someone who has been diagnosed with PAD has an increased chance of having coronary artery disease.
How Leg Pain From PAD Differs From Muscle or Joint Pain
Why Circulation-Related Pain Appears During Movement and Improves With Rest
The amount of pain you feel due to PAD depends on how active you are. PAD will start to hurt when your muscles need oxygen, and it will stop hurting when they no longer require it. This is a very predictable way to determine whether the pain was caused by a vascular problem. In contrast, joint pain may continue to cause you pain long after you have stopped being active. Understanding the difference between these two types of pain is important so that you don’t misdiagnose or undergo any unnecessary treatment.
Differences Between PAD Pain, Sciatica, and Arthritis Pain
Nerve pain due to sciatica can go down along the entire length of the leg and tends to get worse when sitting or making certain movements. Joint pain due to arthritis is generally around a joint. It’s stiffest first thing in the morning (or after long periods of inactivity), and tends to loosen up a little bit with gentle movement, but will become worse after being used for long periods of time.
On the other hand, PAD-induced claudication is caused by walking or exerting oneself, and it improves quickly with rest. Using these distinct differences to locate the source of the problem can help your healthcare provider to accurately assess where the problem is and help them run the appropriate tests to reach a diagnosis as quickly as possible.
Warning Signs That Leg Pain May Be Vascular Rather Than Musculoskeletal
A person’s physical looks may show signs of possible vascular issues. Signs of poor blood circulation include hair loss on the legs, smooth/shiny skin, and slower nail growth than normal. While these findings may not give rise to symptoms and may only serve as a guide during a physical examination, being able to identify them early can lead to faster diagnosis and a larger treatment window.
Risk Factors That Increase the Chances of Developing Peripheral Artery Disease
Smoking, High Blood Pressure, and High Cholesterol
PAD risk is greatly increased among smokers, as smoking also damages the inner wall of the arteries within the body. Having high blood pressure and/or high cholesterol increases the chances of having plaque build-up over time.
An additional consideration when evaluating individuals with symptoms related to PAD is past smoking habits. Even if a patient has not smoked in many years, their risk of developing PAD can still be greater based on their past smoking history.
Therefore, healthcare providers evaluate each of these risk factors separately when diagnosing and developing a treatment plan for a patient with symptoms. Proper management of all risk factors is also vital to stopping how the disease progresses.
Diabetes and Its Effect on Blood Vessel Health
Patients with diabetes typically suffer from both large and small blood vessel disease. Consequently, they’re at a greater risk of developing PAD. By affecting feeling in the feet, diabetes can also lead to delayed awareness of injuries or foot and toe problems. Most patients with diabetes will therefore possess more advanced PAD than patients without it.
As a result, we monitor patients with diabetes more frequently than we do with non-diabetic patients due to their increased risk for developing complications from PAD. It’s especially important to detect PAD at an early stage among patients with diabetes in order to provide appropriate care and prevent potential complications.
Age and Family History as Major Contributors to Circulation Problems
With an increase in age comes an increase in risk for developing PAD. Age and cumulative exposure to risk factors can lead to higher rates of occurrence/diagnosis of PAD in an individual.
One variable that could be affected by genetics is when an individual will develop Peripheral Artery Disease or when providers will start screening for PAD. This is why cardiologists consider age and family history when determining the best time to screen for PAD, as discovering high-risk populations prior to the onset of symptoms is important.
Diagnostic Tests Cardiologists Use to Detect Peripheral Artery Disease in Waco, TX
Ankle-Brachial Index (ABI) Testing to Compare Blood Pressure in the Legs and Arms
The ankle-brachial index (ABI) test measures blood flow to the legs by comparing the blood pressure measured at both the ankle and the arm. At Waco Heart & Vascular, we typically perform ABI testing both at rest and again, after you’ve performed an exercise such as walking. In some cases, patients have a normal ABI test at rest but an abnormal result after walking. This method of ABI testing facilitates the identification of previously unknown diseases in the patient. The ABI test is an easy-to-perform and accurate test that’s helpful in diagnosing disease in the early stages.
Doppler Ultrasound to Evaluate Blood Flow Through Leg Arteries
The Doppler ultrasound allows healthcare providers to visualize how blood is carried through the arteries of the body and locate areas of narrowing, as well as identify their level of severity.
Healthcare providers can evaluate flow patterns (e.g., turbulence), which may show that a blockage may eventually form, thereby helping them make the right treatment decisions. In addition to helping healthcare providers develop a plan of care, Doppler ultrasound is also used to determine whether other types of imaging should be performed.
Advanced Imaging Tests to Identify Blockages in Peripheral Arteries
To detect blockages in the blood vessels supplying the body peripherally (away from the heart), at Waco Heart & Vascular, we may use advanced imaging after other testing has indicated a possible major circulatory issue or if a medical procedure may be performed.
Angiography, which is completed during a cardiac catheterization, provides a sharp, clear image of the arteries and may also provide an opportunity for treatment during the same visit.
Many physicians utilize Doppler ultrasound as the first step to evaluate blood flow and to locate areas of narrowing, as it’s a non-invasive testing technique.
Alternatively, CT angiography (CTA) and MR angiography (MRA) are also used to produce high-quality images of the arteries without the need for a catheter.
Depending on the severity of the patient’s symptoms, the suspected location of the blockage, and whether the purpose of the test is for diagnosing the condition or for planning treatment, physicians will recommend the appropriate imaging test.
Why PAD Should Not Be Ignored
Increased Risk of Heart Attack and Stroke in Patients With Peripheral Artery Disease
PAD is an indication of numerous other ailments in the body and is a sign of vascular disease that’s not simply occurring in the lower body. The fact that you have PAD means that you’re likely to have a higher risk of heart attack and stroke. Thus, evaluating for underlying cardiovascular problems by a heart specialist in Waco, TX, is very often recommended. Treating PAD will help to reduce any cardiovascular risks you have as well. If you ignore these symptoms, you may develop many more serious complications.
How Severe PAD Can Lead to Critical Limb Ischemia
Arterial blood supply to the lower extremities is insufficient to satisfy the resting metabolic demands of the legs, as illustrated by Critical Limb Ischemia (CLI). Severe CLI will lead to severe pain due to insufficient arterial blood supply, ulcers, and chronic non-healing ulcers, as a result of severe arterial blood supply. In advanced cases of CLI, there may be signs of a pale, blue, or black discolored foot or toes.
Because ongoing loss of oxygen to the foot can lead to infection and gangrene, CLI is considered a medical emergency requiring urgent re-establishment of arterial blood supply to prevent the possible need for amputation of the affected limb. Because of the potential for continuous worsening of PAD symptoms, it’s critical to recognize early warning signs.
Why Early Diagnosis Improves Long-Term Outcomes
Detecting peripheral arterial disease earlier than later allows for treatment before there are severe blockages in the arteries. Lifestyle changes, medication, and/or minimally invasive procedures have been shown to improve blood flow, reduce symptoms, and prevent the development of complications such as critical limb ischemia, myocardial infarction, and stroke.
Patients who are diagnosed before having to undergo major surgery tend to have better mobility and quality of life, compared to those who are diagnosed after a major procedure has been performed. Early diagnosis allows for less invasive treatment and better outcomes. Patients who seek care early often respond well to lifestyle changes and medication. Delayed diagnosis may require more complex procedures. At Waco Heart & Vascular, we usually emphasize early evaluations for PAD treatment.
Treatment Approaches for Improving Circulation and Reducing Leg Pain in Waco, TX
Treatment Approaches for Improving Circulation and Reducing Leg Pain
Lifestyle Changes That Improve Blood Flow and Reduce PAD Symptoms
Walking programs that are both regular and organized have been proven to be effective for improving blood circulation in patients with peripheral artery disease in Waco, TX. When patients walk until they feel soreness, and rest, before walking again, it’ll improve their ability to create new blood vessels over time.
Quitting smoking, controlling blood pressure and cholesterol, and maintaining a healthy weight, all substantially reduce PAD symptoms. If someone who is living with PAD exercises regularly, this will help them reduce the severity of their disease and improve their leg function.
Medications That Help Prevent Blood Clots and Improve Circulation
The goal of treating PAD with medications is twofold: to minimize the risk of developing blood clots and to provide improved circulation (blood flow) to the affected area. Medications used to treat patients who have PAD include:
Antiplatelet (Aspirin, Clopidogrel) – Antiplatelet agents are used to reduce the chances of creating a clot; Statins (lowering cholesterol levels and stabilizing plaques); Cilostazol (widening of blood vessels) helps the leg(s) feel better and enables someone with PAD to walk longer distances.
At Waco Heart & Vascular, we may use advanced lipid testing to evaluate total cardiovascular risk factors and the severity of PAD, helping us create the best possible treatment plan for each patient.
Minimally Invasive Procedures That Restore Blood Flow in Blocked Arteries
Angioplasty and stents (or stenting) can reopen narrowed arteries and help restore blood flow through these vessels. Minimally invasive methods are generally used for these types of treatments.
At Waco Heart & Vascular, our physicians may perform an angioplasty or place a stent based on your symptoms and test results. Not every patient needs to be treated with an intervention. So, parts of the patient’s care plan may be to avoid unnecessary interventions, or perform interventions based on the patient’s individual needs.
When Leg Pain Should Prompt a Visit to a Cardiologist in Waco, TX
Persistent Pain When Walking That Improves With Rest
Intermittent claudication is leg pain that you get while walking/exerting yourself, but it goes away after resting. This is a classic symptom of Peripheral Artery Disease. This pattern of pain means that the muscles in your legs don’t get enough oxygen-rich blood supply during exercise. Numerous studies have revealed that as many as 50% of individuals with PAD don’t have pain at rest. Therefore, it’s particularly important to detect PAD early on when walking/exerting.
Our cardiologists at Waco Heart & Vascular encourage patients with even mild, intermittent leg pain to know when to see a cardiologist for leg pain, since untreated Peripheral Artery Disease greatly increases the chances of suffering from a heart attack, stroke, or critical limb ischemia.
Numbness, Weakness, or Color Changes in the Legs or Feet
Persistent numbness, weakness, or skin changes (skin turns pale, blue, or red) tend to mean that blood flow to your legs may be reduced. These symptoms more often than not, represent a progressed stage of PAD and should require a heart specialist to perform a full assessment. Early detection can help with restoring circulation, preventing tissue damage, and reducing the chance of serious complications like ulcers or critical limb ischemia.
Wounds on the Feet or Toes That Heal Slowly
Slow-healing wounds or sores, including ulcers, on your feet or toes can indicate PAD due to the body’s decreased ability to heal tissue after injury because of the decrease in blood flow.
The presence of these types of wounds indicates that there are a significant number of circulation problems and that you should see a heart specialist in Waco, TX, as soon as possible. By treating the underlying problem as early as possible, full treatment may allow for improvement in blood flow, healing of the wound, and prevention of infection or the need for amputation.
Why Patients in Waco Seek Cardiovascular Evaluation for Leg Circulation Problems in Waco, TX
Identifying Circulation Problems Before They Lead to Serious Complications
A lot of people in Waco are coming for evaluations when leg pain or vascular difficulties affect their day-to-day activities. With appropriate early assessments, we can detect the presence of Peripheral Artery Disease early before it becomes a serious issue, such as critical limb ischemia, wounds that are not able to heal on their own, and an increased risk of a heart attack.
After evaluating your leg pain, we begin initiating different types of treatment that can improve the blood supply to your legs, alleviate leg pain, and maintain the long-term health of your vascular system.
Comprehensive Heart and Vascular Testing for PAD Diagnosis
The comprehensive range of services that we provide at Waco Heart & Vascular includes peripheral artery disease (PAD) screening, Doppler ultrasound, stress testing, echocardiography, angiography, and advanced lipids.
In addition to these services, specialized wound care is available to assist patients with advanced disease. This comprehensive approach allows both the heart and legs to be evaluated, therefore, giving us a comprehensive understanding of each patient.
Physician Expertise and Specialties
An expert physician provides the direction for the provision of care and will help guide you through any levels of decision-making regarding whether you need medications, ongoing monitoring, or even need to have an intervention done.
At Waco Heart& Vascular, Dr. Phillip Myatt is an interventional cardiologist specializing in minimally invasive techniques to restore blood flow and manage complex vascular diseases. He’s skilled in determining the type of treatment that’s appropriate for you. Dr. Phillip looks at many factors, not just your symptoms, to determine what type of treatment is appropriate based on your individual condition.
Personalized Treatment Plans to Improve Blood Flow and Mobility
All patients are unique with regard to their respective individual need. Hence, patient care and treatment plans are also going to differ based on the patient’s diagnosis.
For example, James, a 45 years old construction manager, had calf pains from walking. When we did imaging, we discovered that he had moderately narrowed femoral arteries. Rather than undergo an immediate surgical procedure (intervention), James completed a programmed walking regimen and medication therapy over 4 months and doubled his propulsion without any surgical treatment.
Collette, a 50 years old school administrator with diabetes, came to our clinic with a non-healing toe wound. Imaging of the toe revealed multiple blockages on multiple levels, requiring a minimally invasive procedure. Early intervention increased blood flow and prevented limb-threatening ischemia.
These two examples show the differences in how clinical decision-making varied based on their clinical presentation.
Expert Peripheral Artery Disease Diagnosis and Treatment in Waco, TX at Waco Heart & Vascular
Patients who are suffering from symptoms of peripheral artery disease in Waco, TX, such as leg pain during physical activity, cold feet, and slowly healing wounds, should be evaluated for PAD as soon as possible.
At Waco Heart &Vascular, we provide thorough cardiovascular tests and advanced imaging technology with an option for minimally invasive procedures as needed. Often, patients will have advanced lipid testing and/or wound care performed when they have more complicated cases.
In general, when to seek a cardiologist’s opinion on leg pain can be determined by swelling or a decrease in circulation that occurs with activity, but resolves upon stopping the activity. Getting evaluated early can help maintain mobility and your long-term health and wellness. Book your consultation today and get on the path to total health and wellness.
