Peripheral Vascular Disease: When Leg Pain Can Be Dangerous

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By Dr. Christopher Leet

Most people connect hardening of the arteries (atherosclerosis) to heart disease. While heart disease is the most common cause of mortality in both male and female populations, cardiovascular disease affects
many other areas of the body, too. Atherosclerosis impacts the legs, which produces what we
refer to as claudication. The symptoms of this are analogous to the symptoms produced in the heart, which produce angina. This is invariably an exercise-related phenomenon, in which a given amount of effort will produce discomfort in the chest, that is then relieved by resting. The symptoms of peripheral vascular disease manifest in the same manner: only the discomfort is felt in the legs, either one or both, but is relieved by rest.leg pain pwl

The basis for these symptoms is caused by a blockage in the arteries that supply the legs. This is the same sort of blockage that occurs in the heart or the arteries to the brain. While leg pain is common for virtually anyone, the relationship to exertion and relief by rest separates this disease from the majority of muscular and arthritic pains. The risk factors responsible for developing these blockages are the same as heart disease: high cholesterol, high blood pressure, smoking, diabetes, lack of exercise and smoking.

Treatment for peripheral vascular disease has some analogies with heart disease, such as stenting or bypass of blocked arteries, which is similar to those for the heart. However, while there are numerous medications to ease pains in the heart, there are not any reliable medications to treat the claudication in the legs. There are indeed medications for cholesterol, blood pressure, etc., but these are more helpful on a system-wide basis and are not specifically directed at treating the legs. Exercise remains important, although a vascular surgeon may need to repair the artery blockages first.

The mortality risk with peripheral vascular disease is much
less than with heart disease or stroke, but the presence
of this condition implies a more widespread problem in
the body. See your doctor for further investigation of other
areas.

Manassas resident Dr. Christopher Leet, now retired, practiced medicine for nearly 40 years, specializing in cardiology and internal medicine.

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