Johannesburg - Peripheral Vascular Disease (PVD) is an illness afflicting thousands of South Africans. Sufferers live with debilitating pain, unaware that the illness is treatable.
PVD is a slow and progressive vein circulation disorder that may affect any blood vessel outside of the heart including the arteries, veins, or lymphatic vessels. Organs supplied by these vessels, such as the brain and legs, may not get enough blood flow for proper function. However, the legs and feet are most commonly affected.
Narrowing, blockage, or spasms in a blood vessel can cause PVD.
The most common cause of PVD is atherosclerosis, the build-up of plaque inside the artery wall which then restricts the amount of blood flow to the limbs.
One of South Africa’s leading Vascular Surgeons Dr Vinesh Padayachy says that the first early symptoms felt by patients are pain in the calf muscles when they are walking.
He said other symptoms include cramps which forces them to stop walking.
“They have to rest for a while and the pain goes away and thereafter they start walking again but after a few 100 metres the pain will start again requiring the need to stop and rest.
“This is a sign that there may be a blockage in the blood vessels supplying the leg, this early sign is often an indication that they should seek further help,” he said.
Padayachy said that leaving the symptoms untreated results in people having their movement restricted as walking proves too painful.
“Before they know it they won’t even be able to walk 10 metres,” he said.
“Once it has progressed further, they can have constant pain. Pain day and night which is not relieved by simple medications like Panado. They are unable to sleep at night, they often have to hang their legs out the side of the bed to get some relief”.
Dr Padayachy pointed to other symptoms being ulcers on the legs which do not heal despite treatment. He said the ulcers often looks dusky and pale and are quite painful.
“They can also have areas of darkening of the toes, tips of the toes especially which is painful and not healing and finally they can end up with gangrene of the toes. The limbs can sometimes look pale, bluish and cold to the touch.
“Any of these symptoms could be a sign of underlying vascular disease. Unfortunately, most vascular diseases cannot be treated by over the counter medication and patients would need to see their doctor,” Dr Padayachy said.
Once a person decides to seek treatment and after they are referred to a vascular surgeon, they will have a physical examination of the pulses in the lower limbs.
Diagnostic imaging is used such as venous and arterial dopplers.
This test uses ultrasound to look at the blood flow in the large arteries and veins in the arms or legs. Doppler ultrasonography examines the blood flow in the major arteries and veins in the arms and legs with the use of ultrasound (high-frequency sound waves that echo off the body).
He added: “Major advancements made in the medical and surgical field have expanded the treatment options to patients. Treatments can range from minimally invasive surgery entailing opening the vein or arterial vessels in patients that have progressive disease using endovascular devices such as stents and balloons. Patients that are asymptomatic can be put on conservative treatment and managed with anticoagulants,” he said.
Dr Padayachy’s advice on preventing PVD is that people should adopt a healthy lifestyle.
“Regular exercise, low cholesterol diet and quitting smoking can go a long way in preventing the progression of peripheral vascular disease,” he said.