Peripheral Artery Disease

WHAT YOU SHOULD KNOW:

• Peripheral artery disease, or PAD, is a condition that affects the arteries outside the heart and brain. These arteries include the aorta (largest artery) and arteries of the upper and lower limbs, neck, and organs. Arteries are blood vessels that carry blood with oxygen from your heart to the rest of your body. PAD occurs when blood flow to a body part is decreased or stopped. Oxygen cannot get to that body part, and over time, this lack of oxygen may lead to organ damage. This may happen when the artery becomes narrowed, weakened, or blocked. Atherosclerosis, which causes fatty deposits (plaques) to build up in arteries, is the most common cause of PAD.
  
  
• Signs and symptoms depend on what part of the body was affected and how much damage was done. The lower limbs are the first and most common part of the body affected by PAD. You may have muscle pain or cramping in your hip, thigh, calf, or foot. This usually occurs when walking or exercising, and goes away with rest. Over time, you may have severe pain that may happen even at rest, especially while lying down. PAD may be diagnosed through a detailed health history. Tests, such as doppler, ankle brachial index (ABI), angiography, blood tests, or treadmill test may be done. Treatment may include risk factor modification, exercise rehabilitation, medicines, and procedures. With treatment, more serious problems of PAD may be prevented and your quality of life may be improved.

INSTRUCTIONS:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine. Use all medicines given to control other health conditions as directed by your caregivers. These conditions include diabetes, high blood pressure, heart disease, and high cholesterol.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Blood thinners:

Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:

• Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.
  
  
• Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.
  
  
• Take this medicine exactly as your caregiver tells you. Tell your caregiver right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your caregiver uses these tests to decide how much medicine is right for you.
  
  
• Talk to your caregiver about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.

Eat healthy foods:

Choose healthy foods from all the food groups every day. Include whole-grain bread, cereal, rice, and pasta. Eat a variety of fruits and vegetables, including dark green and orange vegetables. Include dairy products such as low-fat milk, yogurt, and cheese. Choose protein sources, such as lean beef and chicken, fish, beans, eggs, and nuts. Ask how many servings of fats, oils, and sweets you should have each day, and if you need to be on a special diet.

Exercise:

Exercise makes the heart stronger, lowers blood pressure, and helps keep you healthy. Begin to exercise slowly and do more as you get stronger. Talk with your primary healthcare provider before you start an exercise program.

Foot care:

Peripheral artery disease decreases your body's ability to heal wounds, so it is very important that you take care of your feet.

• Always wear something to protect your feet from injury. Do not walk barefoot because you may step on a hard or sharp object. If you have ulcers (sores) on your feet, you may need to wear special shoes.
  
  
• Change your socks daily and do not wear tight stockings, socks or shoes. Do not wear shoes that are too small or socks that do not fit correctly inside your shoes.
  
  
• Cut your toenails regularly. Trim your nails straight across to prevent ingrown toenails. You may also file down your toenails. Do not cut your nails into the corners or close to the skin. You should not dig under or around the nail.
  
  
• Look closely at your feet every day. Check for cracks, calluses (hard areas of skin), corns, or ulcers (sores). Tell caregivers if you have any of these problems.
  
  
• Wash your feet daily with mild soap and dry them well. Put moisturizing cream on your feet if there are no open areas and they are dry.

Do not smoke:

Smoking causes lung cancer and other long-term lung diseases. It increases your risk of many cancer types. Smoking also increases your risk of blood vessel disease, heart attack, and vision disorders. Not smoking may help prevent such symptoms as headaches and dizziness for yourself and those around you. Smokers have shorter lifespans than nonsmokers.

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You have new symptoms since the last time you visited your caregiver.
  
  
• You have redness, calluses, or sores on your feet.
  
  
• Your skin has a rash.
  
  
• Your symptoms prevent you from doing your daily activities.
  
  
• You have questions or concerns about your disease, medicine, or care.

SEEK CARE IMMEDIATELY IF:

• You have a wound that does not heal or is infected.
  
  
• You have pain in your toes that does not go away or gets worse.
  
  
• You notice that your legs or feet are turning blue or black.
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand
  
  
• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Peripheral Artery Disease (Aftercare Instructions)