About Peripheral Vascular Disease
Peripheral vascular disease (PVD) is a set of disorders affecting the arteries and veins outside the coronary, carotid and pulmonary vasculature. It occurs when an artery or vein, often in the arms or legs, becomes occluded. Occlusion causes patients to experience pain in the location of the blockage. The severity of pain usually is indicative of the severity of the blockage. Severe blockages can cause blood to pool in the extremities and presents as a bluish tint to feet or hands. If untreated, the tissue may become gangrenous and require amputation.
PVD can be divided into two classifications: arterial and venous. Both have different causes and symptoms. Arterial disorders are often termed peripheral arterial disease (PAD); venous disorders have several causes. PVD also covers a few rarer disorders worth mentioning. Following are some causes of peripheral vascular disease.
Blood clots in veins, or venous thrombosis, are a particularly dangerous cause of PVD. Perhaps the most dangerous problem that can arise as a result of one is a portion breaking away from the clot and migrating into the pulmonary arteries (pulmonary embolism). This can be fatal if the embolus is large enough. The formation of clots has a few different causes; patients that display these tendencies should remain vigilant in their treatments. They can form when damage occurs to the lining of a vein, be it from trauma, infection or injury, especially if a patient displays an abnormal tendency for blood to coagulate (hypercoagulable state). They may form when blood moves slowly in the periphery, or as a result of an inflammation of the veins, called phlebitis.
In healthy veins, a one-way valve system coupled with regular movement keeps blood circulating back to the heart and prevents it from pooling in the extremities. When blood moves sluggishly (stasis) or the valves are malfunctioning, varicose veins develop, usually superficially. Patients that stand for long periods of time are more susceptible to varicosities. While varicose veins are unsightly, they often cause little in the way of dramatic health concerns. Though, they can cause patients some discomfort and swelling. Usually nearby deep veins pick up the blood flow responsibilities.
Peripheral Arterial Disease
Peripheral arterial disease occurs when plaques build up on the wall of an artery and occlude blood flow to the legs, arms, and abdominal organs. These plaques are composed of fat, cholesterol, fibrin and other blood-borne substances. As they grow, they narrow the arterial opening (atherosclerosis). Atherosclerosis is especially dangerous should a clot form. If a clot becomes lodged behind an atherosclerotic plaque, the entire artery can become blocked. This causes a lack of oxygenated blood “downstream” of the blockage, known as ischemia. With PAD, ischemia usually presents as cramping pain in the legs, usually, exacerbated by exercise or uphill walking. This pain is referred to as intermittent claudication.
Raynaud's Phenomenon is a rare disorder of the arteries in the arms and legs. Arterial spasms cause constriction of the minuscule vessels which supply blood to the fingers and toes. It is often experienced on the same digit of both hands or both feet. Symptoms of the disorder include numbness, coldness, tingling or pain and present predominantly in women. Symptoms appear following exposure to cold, cigarette smoking or emotionally stressful situations.
Erythromelalgia (EM) is another rare form of PVD. Intense vasodilation causes hands or feet to display deep redness, intense heat and pain. There is no direct cause identified in most cases, however, in some cases, underlying causes include neuropathy and blood diseases. Symptoms appear following exposure to warm temperatures or exercise.
Yale University Medical Library: Peripheral Vascular Disease
Texas Heart Institute: Peripheral Vascular Disease
American Heart Association: About Peripheral Artery Disease
National Heart Lung and Blood Institute: Peripheral Arterial Disease, What Is
The Erythromelalgia Association: What is EM?
Medline Plus: Raynaud's Phenomenon