• Wednesday April 8,2020

Arterial Disease

Arterial occlusive disease (AVC) or peripheral artery disease (PAOD), as well as the smoker's leg, is colloquially referred to as intermittent claudication. This leads to a sometimes life-threatening, arterial circulatory disorder of the extremities (feet, legs, arms, hands). The main cause of this disease is arteriosclerosis due to an unhealthy lifestyle. Especially smoking, lack of exercise and a lot of fat and high cholesterol food is responsible for the arterial occlusive disease.

What is the arterial occlusive disease?

Arteriosclerosis can quickly lead to a heart attack or stroke.

The arterial occlusive disease is colloquially also referred to as "intermittent claudication". This is because it forces the patient, after a short while, to stop and pause. The gait resembles that of the flaneur, who strolls from shop window to shop window and stops for a moment to look at the displayed goods.

In addition, the arterial occlusive disease is responsible for the so-called smoker's leg. In principle, the smoker's leg is an arterial occlusive disease caused or caused by the patient's long-term smoking.

Especially older people over the age of 65 tend to get this disease. Especially men have a higher risk of smoker's leg or arterial occlusive disease.

causes

The arterial occlusive disease is caused by a circulatory disorder of the extremities. This circulatory disorder is due to a constriction or even occlusion of the main artery or those arteries that supply the extremities.

Constriction or occlusion, in turn, occurs in arterial occlusive disease due to arteriosclerosis. This disease, also known as arteriosclerosis, is the cause of approximately ninety-five percent of patients with arterial disease. Other, albeit significantly rarer, causes of arterial occlusive disease are inflammatory vascular diseases.

Since the vascular calcification in this disease is a creeping and slow progressing process, the effects worsen enormously, especially in the interaction of the risk factors.

Symptoms, complaints & signs

The arterial occlusive disease shows different symptoms that are dependent on the affected body parts and the stage of the disease. If the extremities are affected, the symptoms are the same as in peripheral arterial disease. In the initial stage, the suffering causes no symptoms.

As the arterial occlusion progresses, it eventually becomes stressful. These occur where the arterial occlusion is pronounced. This can be in the legs, for example, or in the form of angina pectoris. These stress pains initially appear only after or during a physical activity.

Resting pain occurs in the still further course of the illness. Finally, the last symptoms are inflammations, ulcers and necrosis of the poorly perfused parts of the body. The loss of tissue - especially on the extremities - is accompanied by a loss of sensory abilities. Amputations may be necessary in severe cases.

But not only the extremities are affected by the narrowed vessels. Narrowed blood vessels can cause a variety of symptoms in the body. For example, it can lead to circulatory disorders in the brain and resulting thromboses carry an increased risk of strokes, heart attacks and embolisms. In addition, constricted vessels contribute to general weakness, as nutrients and oxygen are not optimally transported.

course

The arterial occlusive disease predominantly affects the lower extremities or their arteries. Depending on the stage of the disease, the symptoms range from subjective discomfort to stressful onset of pain and the consequent limitation of walking distance, to painful and gangrenous stress-independent ulcers that require amputation.

The arterial occlusive disease is therefore initially unnoticed, since the occlusion of the artery is creeping - just as little as high blood pressure, for example, an arterial occlusion in the initial stage does not hurt. It takes an average of ten years longer for women to diagnose arterial disease. It is therefore all the more important to know the main risk factors for arterial occlusive disease.

In addition to smoking and diabetes mellitus, these are high blood pressure and lipid metabolism disorders. The last three factors occur especially in overweight. In this respect, the first and best way to prevent arterial disease is to reduce obesity and stop smoking immediately.

For example, in men as well as women who smoke, the onset of illness is on average fifty-five years old. In non-smoking women at sixty-five years. And even though men have a three times higher risk of contracting arterial disease, this benefit of smoking women is nullified. They also belong to the main risk group.

Unfortunately, the first signs of arterial disease are often neither true nor taken seriously. Most sufferers do not go to the doctor until they feel more pain in their calves when walking. But even those who go to the doctor, the start of treatment of arterial disease can often delay by misdiagnosis.

Finally, pain in the calf may also be an indication of orthopedic problems, such as a torn muscle. The Dangerous thing about it: The arterial occlusive disease not only affects the legs, but also those arteries that supply the heart and brain, are narrowed. This means a high risk of a heart attack or stroke.

complications

Complications that develop from arterial occlusive disease are always due to a lack of supply of oxygenated arterial blood to certain areas of the body. Accordingly, the resulting complications can be very different. They range from barely perceptible to immediately life-threatening situations.

For example, coronary artery disease, which is also associated with arterial occlusive diseases, may develop angina pectoris associated with chest pain or, in the case of total occlusion of one of the main coronary arteries, even an immediate life-threatening myocardial infarction. If one or both renal arteries are affected by arterial occlusive disease and have higher-grade stenoses of more than 75 percent, renal hypertension first develops.

The kidney is increasingly releasing the vasoconstrictor hormone renin, which, through the mechanism of vasoconstriction, causes increased blood pressure and may cause complications associated with high blood pressure. The low supply of the kidneys with arterial blood can severely impede the function of the kidneys and as the ultimate complication it can come to a renal infarction analogous to myocardial infarction.

The most well-known arterial disease is probably peripheral arterial disease (PAOD), which affects the lower extremities. The disease, which affects smokers above average, is also known as intermittent claudication because those affected often like to stand in front of shop windows to hide their disease due to severe leg pain.

Most of the mentioned complications resolve after restoring blood flow through the affected arteries. The prerequisite for this is that no irreversible limits have been exceeded.

When should you go to the doctor?

The arterial disease is a progressive disease that can lead to different consequences. These include peripheral arterial disease and coronary heart disease. The symptoms of these (and other) conditions are usually serious for the person concerned.

If a person realizes that running, lifting the arms or standing is more difficult, the limbs feel stiff after a slight load and a feeling of weakness generally prevails, arterial occlusive disease can be the cause. An occurring angina pectoris - pain in the chest area under load - is a clear sign. Both conditions should be urgently examined by a doctor and treated if possible.

In case of suspected arterial occlusive disease, a doctor should always be consulted as this condition may be greatly delayed in its development. People who belong to a risk group should be examined as a precautionary measure. This includes smokers, obese and people with other underlying conditions. In addition, a high-fat diet promotes the development of an arterial narrowing.

Patients already suffering from a diagnosed arterial disease should consult the attending physician in case of acute deterioration of their condition. Depending on the equipment and specialization, a GP can be consulted for the first diagnosis. Other - possibly invasive - measures require a visit to a vascular specialist.

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Treatment & Therapy

The treatment or treatment of arterial disease by a vascular physician has the goal to prevent exactly this. The treatment is based on the immediate elimination of risk factors. This includes abstaining from nicotine, lowering cholesterol and stopping high blood pressure and diabetes.

A consistent walking training in the context of the so-called vascular sport leads to an improvement in the blood flow in the legs, because the movement of the muscle forms around the bottleneck new blood vessels or extends the existing. This way, the pain can also be relieved by increased activity. Schonen would be the wrong way here. In addition, any form of exercise contributes to lowering blood lipid levels and blood pressure. Endurance sport is the best medicine for the treatment of arterial occlusive disease.

Outlook & Forecast

First and foremost, the prognosis for arterial occlusive disease depends on whether causative factors can be eliminated. A progression of the disease can only be prevented, because even a surgical intervention is no guarantee for a lasting persistent complaint-free. The bottleneck can sometimes close again. Life expectancy is shorter in patients with arterial disease because they usually suffer from other vascular diseases and the risk of heart attacks and strokes is significantly increased.

The prognosis is positively influenced by preventative measures in the form of a healthy lifestyle (eg achieving a normal body weight, abstinence from cigarettes, diet low in fat and cholesterol, physical activity). If the arterial occlusive disease is based on an embolism and its source can not be eliminated, a lasting prognosis for the prevention of blood clotting is necessary for a better prognosis.

If a thrombosis is the cause of the arterial occlusive disease, then a therapy with so-called antiplatelet agents is performed, which can also positively influence the prognosis. For a favorable prognosis, the participation of the patient is always necessary. If the lifestyle is not adjusted accordingly, then the prognosis is rather bad.

aftercare

Immediately after surgery, the patient must first stay in bed. Pulse, blood pressure and bandage are monitored regularly to detect complications as quickly as possible and take countermeasures. Even during the operation, the patient receives heparin, which inhibits blood clotting.

This is to prevent blood clots from forming in the operated area or at other preloaded body sites. The administration of heparin is also regularly followed by surgery. In the period after the operation, the blood values ​​are also regularly monitored to detect and treat inflammation or other discrepancies.

Later, after the operation has been performed, the patient has to go to check-up at the doctor. First, the control takes place after four to six weeks, later every six months and finally only annually. In these tests, the doctor assesses whether the blood can continue to flow well. If not, the question of a new operation may arise.

In order to prevent future arterial occlusions, the patient can take preventive care himself with a healthy lifestyle with a well-balanced diet, sufficient exercise and abstinence from smoking. Medication prescribed by the doctor should also be taken as directed.

You can do that yourself

The arterial occlusive disease can be delayed in its mild stages a little, or even greatly delay in their development when the person changes his lifestyle.

Important risk factors should be banished as far as possible from life. These include smoking, eating large amounts of fat and lack of exercise. Instead, the focus should be on a light diet rich in vitamins and minerals. Because the extra nutrients and the better metabolism help the body to form new vessels. This improves peripheral blood circulation and prevents further suffering.

The oxygen deficiency of the tissue must also be compensated. Sporting activities provide better blood circulation and increase the lung volume sustainably, so that the blood becomes acidic, the tissue can be better supplied despite arterial narrowing. Especially endurance sports such as swimming, running or cycling are available here.

Even regular walks can help. In addition, attention should be paid to breathing. A conscious and deep breathing leads to a better supply of oxygen.

In case of stress-related pain it can help to stretch the legs (or arms), gently tap or rub. However, the measures merely alleviate the symptoms.


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