Can Peripheral Artery Disease Affect the Heart?

Patients with peripheral artery disease have a higher risk of heart attack or stroke than patients with other diseases.

Peripheral artery disease is a condition in which extremities (usually the legs) do not receive sufficient blood flow due to the narrowing of or blocks in arteries. Peripheral artery disease is also likely to be a sign of more widespread accumulation of fat deposits in the arteries (atherosclerosis or plaque). This condition may reduce blood flow to the heart, brain, and legs.

Peripheral artery disease is a warning signal that there are high cholesterol deposits (plaque) in the arteries. Patients with peripheral artery disease have a higher risk of heart attack or stroke than patients with other diseases. Medical attention is required in these patients to lower cardiovascular risks.

The arteries become harder and narrower due to fat and cholesterol deposits. This condition is called atherosclerosis. This is the most common cause of peripheral artery disease. Below are a few common factors that increase the risk of peripheral artery disease:

• Age over 50 years
• Smoking
• Limited physical activity
• High cholesterol
• High blood pressure
• Overweight or obesity
• Diabetes

Patients with peripheral artery disease have muscle pain or cramping because of inadequate blood flow to the legs. This type of pain is called claudication. Symptoms are worse while walking or climbing stairs, but stop when you rest.

It can affect different muscle groups, including:

• Buttocks and hip
• Calf (most common)
• Foot (less common)
• Thigh

Few patients have a sense of burning or numbness. In case of an advanced form of peripheral artery disease, your toes or feet might hurt even while you are resting.

Common signs and symptoms of peripheral artery disease include:

• Changes in the color of your legs
• Difficulty in sustaining an erection during sexual intercourse (erectile dysfunction)
• Leg weakness
• Legs that feel cooler than your arms
• Loss of hair on your legs
• Fainter pulse in your feet
• Shiny skin on your legs
• Slow toenail growth
• Wounds or sores on toes or feet that do not heal well

The treatment of peripheral artery disease depends on the severity of the disease. Usually, physicians choose from three types of approaches to the patients depending on the risk/severity of the disease.

Prevention: When an individual is at risk of developing peripheral artery disease, the doctor usually recommends prevention methods.

• Blood pressure and cholesterol control 
• Eating a healthy diet, which lowers the risk factors of heart diseases and peripheral artery disease (e.g., egg whites and green leafy vegetables).
• Exercises to keep the body fit
• Quitting smoking and drinking alcohol 

Medications: Because peripheral artery disease reduces the blood flow to your limbs, it is important to improve that flow. Medication is the best approach for the treatment of peripheral artery disease. Below are a few common medications used in treating peripheral artery disease:

• Drug cilostazol eases symptoms in many people
• Pentoxifylline  can help with poor circulation
• Aspirin therapy and anticoagulation medication, such as Plavix (clopidogrel), improves blood circulation, and prevents occlusion of blood vessels, hence it is considered as the best treatment of peripheral artery disease.
• Heparin and warfarin prevent blood clotting
• Other drugs to control cholesterol, blood pressure, and diabetes are recommended, along with above medications

Surgery: Doctors usually use three surgical methods for severe conditions of peripheral artery disease which include:

• Angioplasty: In this procedure, a catheter, which is a thin tube, is used to put a tiny balloon into an artery. When inflated, the balloon pushes plaque out to widen the artery and restore blood flow. Doctors might also put a mesh tube called a stent into the artery to keep it open.
• Using a bypass graft: A surgeon usually uses this method to route blood flow around a blocked artery. Bypass surgery involves using a vein from the body or a portion of a synthetic vessel (known as grafts) to create a detour around the blockage. One end of the graft is sewn to the damaged artery above the blockage and the other end is sewn below the blocked area. Blood flow is then able to bypass the area of narrowing or blockage. 
• Endarterectomy: It is a procedure in which the surgeon cleans out plaque buildup inside the artery of the affected leg or arm.