Peripheral Vascular Disease

Peripheral Vascular Disease(PVD) or Peripheral artery disease (PAD) is a condition where the arteries supplying blood to the limbs and internal organs get blocked as a consequence of atherosclerosis. Fatty deposits get built up in the arteries and reduce the flow of blood to the organs being supplied by the peripheral arteries. Atherosclerosis is by far the leading cause for Peripheral Vascular Disease. Diabetes is a condition that puts a person at high risk for PVD. Smoking and obesity increases the risk for Peripheral Vascular Disease. Persons who are obese and suffer from hypertension are at higher risk for Peripheral Vascular Disease. A sedentary lifestyle without any exercise should be avoided.

Intermittent claudication is noticed in patients suffering from Peripheral Vascular Disease. Symptoms associated with Peripheral Vascular Disease include numbness or tingling in the limbs, sores that do not heal and pain in the buttocks. A patient suffering from Peripheral Vascular Disease notices changes in skin color and temperature. There may be a dull and cramping pain in the calf, thigh and hip muscles. Ankle Brachial Index (ABI) involves a ratio of the blood pressure in your ankle to the pressure in your arm. Angiogram is a dye test that reveals any possible blockage in the arteries. Ultrasound Doppler Test uses imaging to check for plaque build-up in the arteries. Duplex ultrasound helps in accurate detection of the size of the artery stenosis and the extent of blockage.

Medication is prescribed to eliminate the narrowing of the arteries thereby improving the heart efficiency. Anti-platelet or anti-clotting agents such as cilostazol and pentoxifylline or aspirin and clopidogrel help in improving blood supply to the extremities. Heparin and Warfarin are anticoagulant drugs that can prevent blood clotting. Blood viscocity is controlled to improve blood flow. Drugs to control hypertension and cholesterol may also be prescribed. Bypass surgery allows a new blood route that circumvents the blocked areas of the peripheral arteries. Endarterectomy is a surgical procedure whereby a surgeon cleans out plaque buildup inside the artery of the affected leg or arm. Cryoplasty, a newer form of angioplasty uses liquid nitrous oxide to open a narrowed artery and destroy the plaque within. Regular supervised exercise can reduce symptoms of intermittent claudication.

Atherosclerotic Vascular Disease

Atherosclerotic Vascular Disease affects nearly 10% of the population over the age of 65 years. It is noticed more commonly among men. Atherosclerotic vascular disease is probably one of the most common causes for death and disability. Atherosclerotic peripheral vascular disease is a condition where there is a build-up of plaque in the arteries outside the heart. The thickened arteries constrict the flow of blood. This leads to inadequate supply of oxygen to all parts of the body. The mortality rate for this vascular disease is high and there is possibility of loss of limb too. Typically the limbs, kidneys and neck are affected. The symptoms of atherosclerotic peripheral vascular disease include numbness and tingling feeling in the limbs, sores that do not heal and dull, cramping pain in the hips or thighs. Claudication or pain in the lower extremity muscles is a common symptom. Smoking increases chances of peripheral atherosclerotic vascular disease. Other risk factors for atherosclerotic vascular disease are obesity, coronary heart disease and lack of exercise.

ABI (Ankle/Branchial Index) is a popular test that helps in detecting atherosclerotic vascular disease. Angiography is a special x-ray that helps in tracking artery blockages and narrowing. Ultrasonograpy and MRI aid the physician in non-invasive diagnosis of atherosclerotic vascular Disease. Simple tips to keep atherosclerotic vascular disease at bay:

Cold Burn

Cold burn or frostbite occurs when the skin is in touch with an extremely cold body. Extreme cold can cause damage to the skin and underlying tissues. For example, if there is a prolonged contact of the skin with moderately cold body like snow or very cold bodies like dry ice, liquid helium or liquid nitrogen for a brief period, cold burns will occur. Here heat is transferred from the skin and organs to the cold body that is in contact. In other kinds of burns, the body that causes the burn is hotter and heat is transferred to the skin or the organ.

Symptoms of frostbite include pins and needles sensation and then numbness in the area. Initially there may be throbbing or aching. The affected part seems to become insensate. In severe frostbite, when the tissue starts to freeze, the skin at that area may appear white and numb. In the affected areas, abnormal accumulation of blood takes place. In addition to accumulation of body fluids, a blood clot may form thereby preventing blood circulation around the area resulting in tissue decay. Normal functioning of the body is disturbed because of cooling of the internal organs, which will lead to a critical condition called hypothermia. Cooling of the brain or heart is very dangerous.

If hypothermia is noticed, treating it should be the priority. Blisters are noticed when there is very severe frostbite. It may also damage tendons, muscles, nerves and bones. Gangrene is inevitable in the case of very severe frostbite. Frostbite may affect any part of the body. The most vulnerable parts are hands, feet, nose and ears. Recovery may be significant when the skin and underlying body tissues are injured and it may be permanent if there is injury to the blood vessels. If gangrene follows, the affected part may have to be amputated. When warming up of the affected part begins, the patient will experience intense pain. There will be tingling or burning sensation in the affected area also.

People taking beta-blockers that decrease blood flow to the skin and those who suffer Peripheral Vascular Disease are at risk when exposed to cold for a prolonged period. Any person who is exposed to extreme cold for a long period is susceptible to frostbite. Diabetes, peripheral neuropathy or Raynaud's phenomenon are some conditions that may have increased risk of cold burns. Smoking and windy weather when the rate of heat loss from the skin is more will hinder the healing process. Cold burns at the work place are common. People who work in factories where they may come in contact with metal surfaces that are at extremely cold temperatures are prone to cold burns. When the skin is moist, they may receive almost instantaneous cold burns.

Prevention of cold burns
Extreme cold, wet clothes, high winds and poor circulation are some of the factors that can contribute to cold burns. Tight boots or clothing and conditions like cramped positions, some medications, smoking or alcohol can cause frostbite. Wearing appropriate clothing in winter when the temperature goes below normal and will help. Winter clothes like mittens, layered clothing that is wind-proof and water resistant gives good protection.

First Aid for cold burns