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What's a cardiologist got to do with leg pain?

  • There are certain medical conditions that test the convincing abilities of a doctor while explaining it to his or her patient lest it should appear Latin and Greek to them. For a cardiologist, peripheral arterial disease (PAD) is one such condition. Even for a gullible person, it becomes difficult to take home the point that something like painful cramps in legs or hip – the usual symptoms of PAD — can actually result in a fatal heart attack if there is no timely intervention. Alternatively known as Peripheral Vascular Disease (PAD) involves narrowing of blood vessels in the leg (sometimes in arms in rare cases), restricting blood supply to the affected area. In several studies, researchers have established that there is higher possibility for patients with PAD to get coronary artery disease, heart attacks or strokes in their lifetime than those otherwise.
  • The likelihood for PAD increases further in chain smokers as they are the ones with the greatest risk factor. It does not need much explaining to let you know that one rarely takes preventive action and realizes the peril till the eleventh hour only after the problem hits  him or her. What’s shocking is that during my long years of practice across hospitals like NIMS, Yashoda Hospitals, Prime Hospital, Sunshine and at Maxcure Hospitals, I have noticed that  less than 25% PAD patients turn up at the right time for treatment. The rest realize it but too late. The consequences for delayed intervention may not be fatal in most cases but the damage would have been done as one may end up with an amputated limb.
  • Tricky condition
  • The problem with PAD is that patients – especially senior citizens  – may mistake the usual accompanying symptoms as normally associated to the ageing process but it’s not. This may not just delay in diagnosing the condition but also the right specialist one must see in such cases. Hence, it is important to understand the symptoms of PAD before one can take up appropriate action.
  • Symptoms of PAD
  • The pains in the leg that one experiences while walking at the neighbourhood park initially disappear after some resting but the problem recurs until the condition gets worse.
  • During this time, pain remains even when the patient is in resting position. The affected limb gets colder and there is a feeling of numbness too. Some other symptoms that one must watch out for:
  • You develop painful cramps after exercise or certain physical work
  • Numbness in legs
  • Toenails don’t grow properly
  • Gangrene sets in
  • Causes:
  • In majority of the cases, the cause for PAD is attributed to what is medically known as atherosclerosis – a condition where accumulation of fatty substance (cholesterol) on the inside lining of the arteries form into yellow deposits called atheroma.
  • If not managed on time, these fatty deposits restrict blood flow through the arteries as it gets narrower and narrower.
  • Diagnosis:
  •  Usually, PAD is diagnosed based on results from ultrasound or angiography.
  • Treatment:
  • The treatment for PAD differs from patient to patient but medical management of the condition through drugs is more common than procedural/surgical treatment.
  • Procedural treatments may range from bypass surgery to arterial reconstructive surgery to balloon angioplasty or amputation based on the severity of the problem in a patient.
  • Well, insurance can take care of the treatment costs – if you happen to turn up belatedly — but why face such a predicament in the first place?
  • Best step forward:
  • Preventive treatment for PAD is by far the most advisable one as one can keep it at bay  by sticking to a healthy lifestyle.
  •  No smoking, exercising more often, eating a low-fat diet and maintaining a healthy Body Mass Index (BMI) can do the tricks but ironically, these unsolicited suggestions seem to be too much to follow for many people.
  • Get well, soon.

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