Peripheral artery disease: Pathophysiology, Causes, Symptoms, Diagnosis and Treatments, Animation

(USMLE topics) PAD: Pathophysiology, Causes, Signs and symptoms, Complications, Risk factors, Diagnosis and Treatments.
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Voice by: Ashley Fleming
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Peripheral artery disease, PAD, is a common circulatory condition in which peripheral arteries are narrowed, reducing blood flow. While PAD can occur in any organ or body part, the lower limbs are the most commonly affected.
The major cause of PAD is the building up of plaques in arteries, known as atherosclerosis. Plaques are deposits of lipids, fibrous tissue and calcium, that accumulate slowly overtime. Less commonly, an artery may suddenly be blocked by a blood clot, or embolus. Rarer causes include blood vessel inflammation, injury, or unusual anatomy of ligaments or muscles.
The impact of reduced blood flow, or ischemia, is most remarkable when there is a higher demand for blood supply, such as during physical activities. This is why people who are not very active may not experience any symptoms initially. It also explains the most tell-tale sign of PAD, known as intermittent claudication - a painful or tired feeling in the legs that occurs while walking, but is rapidly relieved by rest. The affected leg and foot may lose color and feel cold, especially when the foot is elevated. There may also be a lack of growth of toenails and hair.
The location of pain depends on the site of obstruction. The more proximal the site of blockage, the more widespread the pain. The calf is the most common site of pain.
As the disease progresses, patients may experience pain even during rest. This advanced stage is known as critical limb ischemia, a chronic, slow-developing condition. Patients may develop ulcers that heal slowly or not at all; and death of tissue, or gangrene, may occur. The risk for loss of limb is significantly increased at this stage.
Acute limb ischemia happens when there is a sudden block of blood flow, typically due to an embolism or thrombosis. Acute limb ischemia is an emergency threatening loss of limb.
Any factors that increase risks for atherosclerosis also increase risks for PAD. Because atherosclerosis can affect any artery in the body, PAD patients are also likely to have coronary artery disease or carotid artery disease.
Diagnosis is based on symptoms, medical history, physical exam, and a number of tests.
The purpose of the physical exam is to look for signs such as weak pulses, whooshing sounds of obstructed blood flow, and evidence of poor wound healing.
Blood tests are done to evaluate cholesterol, triglyceride, and blood sugar levels.
Ankle-brachial index test, or ABI test, is commonly performed to compare blood pressures in the ankle and the arm. An ABI lower than 0.9 indicates PAD.
Imaging procedures may be performed to identify the affected arteries.
Treatments aim to relieve symptoms, re-establish blood flow to reduce risk of losing a limb, and stop progression of atherosclerosis to lower risk of heart attack and strokes. Treatment options include lifestyle changes, exercise programs, medications, and/or procedures to open or bypass blockages in the arteries.

[@Alilamedicalmedia]

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[@_s_4412]

I was diagnosed with peripheral artery disease in my early twenties. After about 25 years on blood thinners I adopted a plant based diet. I've been vegan for about 8 years now and don't take any medication and feel fine.

[@NicH294]

I just got diagnosed (24)

[@_s_4412]

@@NicH294I'm sorry to hear that. Just know that there are things you can do or change to lead a pretty normal life. I adopted cycling and swimming, and gave up running when I was 23. Eat a healthy diet, and if you smoke, try to quit 🙏

[@jigolo_gaming]

Over sitting on chair I got

[@KT-se2mk]

how are you today ? i also got diagnosed 25 , and do a surgery . now 5 years since the surgery . i really dont know this PAD can go or not

[@Aisucks]

Did you become more physically active?

[@saramohamedahmed6418]

Thank you so much for your help and effort ❤

[@Alilamedicalmedia]

You're welcome 😊

[@Roseenmarie]

this was great, thank you

[@dr.vicnelvictorianelima6477]

Many thanks for such vital information

[@gentlefistinfinity9780]

If I had to write my exam tomorrow after that explanation I would crush it. Thanks for the information 👍🙏

[@upcomingstudent7416]

It's very useful 🤗🤗🤗😄

[@Leoviliti1]

It's been many years now where I've not gone to my GP about this though I've tried to . But four times due to staff shortages they've cancelled on me...and now Ive given up trying.. I've not had to shave my legs for a few years now .barely any hair growth and extremely shiny.. If I exert myself by walking up a hill ...symptoms are terrible..my calves are in sheer agony and spreads to my feet .. and it takes days to ease the pain They become so hot and inflamed and throb continuously .. I've also got COPD.. so breathing for me is awful at the best of times.. I gave up smoking over a year ago but nothing has helped ease anything.. The lower back suffers extremely also. 🥺

[@michaels999]

You could try a non citrus form of Quercetin it usually helps with breathing issues

[@dr.kunalrajput4486]

Very useful information... Easy to understand...👍

[@soccerlegendsmonster]

Nice

[@yasharch2232]

Wow amazing thank you

[@anonymousperson2578]

Excellent video. Thank you!

[@zestydude87]

My 89 year old mother is going through this right now...she's in a lot of pain and has to get surgery done soon.

[@spockboy]

Hope she's okay.

[@zestydude87]

@@spockboy she had the operation about a month ago, and she's back on her feet again and no more pain

[@valenzuela9107]

​@@zestydude87 HI, what type of surgery?

[@zestydude87]

@@valenzuela9107 the doctors had to go in and clean out the arteries in her legs to get better blood flow...it helped her tremendously.

[@tracymarie5184]

@@zestydude87 I had it done in at the end of March and I had some relief but I feel like I'm still having shortness of breath when doing just lil things and I still have a little bit of swelling in my ankles too... NOT everything works for them some people it doesn't, that's with anything tho. But get an ultrasound appointment quickly...Best of luck to you!!! 🙌👌🤞👍💯

[@user-qs5qt6bx4m]

Good

[@muhammadjunaidali769]

awesome

[@MrMorisman]

I am 60 years old and I had the left external iliac vein blocked for a long distance, when I walked fast I had cramps in my leg and on the hill, I had no pulse from the groin to the sole at all, I had an ileo-femoral bypass, the operation was the nightmare of my life, recovery, constipation, I slept on my back for 1 month, without lifting anything, I couldn't even bend down, the operation didn't work because I took out the splints at 8 days instead of going at 2 weeks, now 3 months have passed and I have a pulse on the whole left leg, the belly on the left side is still swollen, it says that it will deflate in 6 months, I'm waiting, the problem that bothers me is that it would be better not to do the operation and the body develops other veins that would have fed the muscles in the leg, that's it my big dilemma

[@zahidjamal4122]

Hope you get well soon!

[@Scrat335]

I have this. Exercising a lot but it's very painful. I can walk short distances but the limit is 500 steps before I have to stop. A chair is your worst enemy.

[@rambobrazy8411]

@@KoalaBeer. theres no fixing this my friend it gets worse with age to youll be in a wheelchair by 50

[@margaretlion2073]

So it’s not reversible??

[@Scrat335]

@@margaretlion2073 No. They do have meds to help such as Cilostizol but one side effect of that is it makes the chance of strokes more likely. I tried it but it made no difference other than to make me a little loopy.

[@margaretlion2073]

That sucks I been doing lot of reading seems like walking is the best bet

[@Scrat335]

@@margaretlion2073 Do you have it? Walking, toughing out the pain helps me. At least it's not getting worse. I also spend a lot of time on my feet at work.

[@mabondavis4838]

very nice and informative video on this disease. i want to suggest one wonderful herb for this disease that is Arjun. this herb is very useful in the treatment of heart disorders=. i took these capsules for 5 months on daily basis now my heart condition is very fine.

[@ikidzfaridabad3304]

Hey from where we get this herb and it cures permanently to the disease ?

[@teresa985]

🙄 Lol Please reply davis

[@shreysom2060]

@@ikidzfaridabad3304 I guess he is referring to Arjun chaal

[@leraz2417]

mabon davis where we can buy that herb Arjun?

[@madhavinallan3621]

@@leraz2417 amazon, ayurvedic product

[@mustafaakbar2552]

I get sudden heaviness in left leg and increase in heart rate with tightness in jaw

[@samjohnson4609]

I had this with a bad case of Covid in 2021 and all they could do was give me muscle relaxers. Called it spasticity

[@ImranKhan-zj8ly]

Sir.my age 35 yreas old my right leg side groven area same vadio . problem advance plz

[@satin4everg]

Pain in left leg calf muscle on putting weight on the leg. Pain lasts for 1 second and goes away as soon as weight is lifted. Can this be PAD or circulation problem Pain?

[@Roseenmarie]

this does not sound like PAD, it sounds like a nerve or muscular issue.

[@satin4everg]

@@Roseenmarie oh ok, thanks for the reply 👍

[@MSD-ii2qe]

@@Roseenmarie my lower left leg & foot feels very tight & numb for about a week now I'm a diabetic so I don't know if it could be cause from sciatic nerve pain

[@Roseenmarie]

@@MSD-ii2qe you need to go and see the doctor STRAIGHT AWAY

[@boethia7367]

My sister has a slipped disc that presses on a nerve. She's obese and the Dr said if she can lose 100+ pounds it should relieve the pain. She is ~400 pounds though.

[@hettiegibbs8911]

What is treattment.

[@ImranKhan-zj8ly]

My years is 35 year old and same pain after 10 year plz advise me what treatment use?

[@cdcd4358]

Chiropractor and acupuncture treatment

[@STONE69_]

Low fat, sugar, salt and walk every day.

[@ankitraghuvanshi5514]

Brother kindly contact me I maybe of some help to you...

[@axcelraegan2116]

i think i have this disease, I can only walk up to 10-20 minutes till both legs too painful to walk. Even trying to sleep, cant even straight either of my legs its also painful. Even standing for few minutes. Is excersing and loosing weight to normal can help lessen the pain? or neither cant help it? I really think it got worst because my leg cant handle my weight anymore 5.7, 83kg.

[@STONE69_]

Don't eat any fried foods, steam or boiled. No fatty foods, animal fat, eggs, sweets, lower your salt intake, drink water or tea no sugar. Walk every day, stop and rest when you feel the pain, try walking farther each week. Take your diet and walking seriously. ... These procedures such as surgery and stenting, should be a last resort and can be problematic. I think you are young and can take the steps to get better without these interventions.

[@c_2519]

@@STONE69_ should I do the same then my ight leg has a bald spot I don't remember being there and my shin used to hurt when I walked but now the pain is gone but when I had the shin pain the bald spot on my leg wasn't there it only appeared yesterday I might be tripping maybe it was always there but I felt like I had less hair I'm 14 btw

[@STONE69_]

@@c_2519 the symptoms to look for are how far you can walk, Do you get pain behind the calf, your toe nails may not grow as fast or might grow into the skin, and when you walk a lot, it will damage your feet, such as a blister etc In any event, if you have these symptoms, you should walk every day, and reduce to a low fat, salt, sugar, diet. This could save your legs and your life.

[@c_2519]

@@STONE69_ I have no problem with walking a long time can walk as much as I want I also don't have pain behind the calves my I'm not sure at what speed my toenails grow but I for sure now they ernt going into the skin like in the side bit and me walking alot won't damage my feet in anyway

[@STONE69_]

@@c_2519 you're the one that made the comment, like you had a problem. maybe you're just playing here.

[@superoli5308]

I cant feel my skin (certain part not all) of my both calves. No pain when walking, no discolorization of my skin, or etc. I just can’t feel my skin. Can this be a sign of PAD? Is anybody here can relate? Its been there almost a year now.

[@bhatasif4957]

I have same symptom buddy my side heels are numb

[@shajianowshin4108]

I feel behind the knee throbbing pulse? Calf pain .. both legs feeling pulse .. anyone here feel the same !please help

[@ankitraghuvanshi5514]

Yes you may contact me I know the condition..i maybe of some help to you...

[@nopressurenodiamonds5566]

I have twitching and pulsing behind my knee and was just told they suspect artery disease. I also get cramps in my butt, calf, and legs feel heavy when I wake up in morning. I also have puffy face, swollen hands, weakness in my arm and prominent veins.

[@amitdivakar2113]

my condition 1 year ago i got burning sensation in lower back hip area it was terrible i did mri there was nothing there I felt like something is pulsating in hip lower back still I feel pulsating which doctor i should see?

[@nidhisindhwani9871]

Same with me any suggestion plz help

[@ankitraghuvanshi5514]

Same with me its arterosclerosis... kindly contact me if you want more help...

[@nidhisindhwani9871]

@@ankitraghuvanshi5514 plz elaborate this condition .. n help

[@nidhisindhwani9871]

@@ankitraghuvanshi5514 but my cholesterol level is normal ..

[@ankitraghuvanshi5514]

@@nidhisindhwani9871 cholesterol is not the key to it...

[@Genkai7666]

Is it weird if my pain in calves gone after i drink a glass of water? Because I diagnosed myself with PAD because i have very similar symptoms like when walking my calves will hurt so bad the more i walk. But then after i drink water it get better. Is it possible that u get this kind of pain cause of dehydration? I never have this kind of situation before

[@Genkai7666]

I do have health anxiety before. But this time the pain is kinda real to me cause i can’t barely walk cause it hurt so much when i walk,have to take some rest to get rid the pain away. Is it possible to have PAD in 24 years old?

[@danielfreemanreels4053]

Go to the doctor

[@Genkai7666]

@@danielfreemanreels4053 already did,doctor said it caused by muscle strain after intense workout. Now i need to take weeks of rest to recover from it. Getting better now,its just my mind playing trick with me cause i have health anxiety i freak out after i google about my pain and it said that i have PAD lol

[@rayfon433]

You can't just diagnose yourself with a cardiovascular disease bro 😂🤣

[@Scrat335]

It could be your feet. Experiment. Use shoes with heels.

[@mariaarroyo5223]

or kidney

[@princess53677]

I am 29 and I am suffering from this. both legs

[@teeyonaechols3934]

WHAT DO YOUR DOCTOR DO TO TREAT YOURS

[@nidhisindhwani9871]

Pl guide

[@RTMDPropertymaintenance]

Legs feel tired during daytime. Sitting in truck my thighs ache after awhile - until I stand up. Do have ED Thinking I have this. Not diabetic. Never smoked. Don’t drink. 6’ tall 185lbs.

[@ajharmiah2692]

Do you eat healthy or bad? Also are you a sedentary person?

[@RTMDPropertymaintenance]

@@ajharmiah2692 I drive trucks but out of the cab frequently. 30 times a day. Do my yard work and maintain 37 acre property. I don’t think I’m a sit around person.

[@ajharmiah2692]

@@RTMDPropertymaintenance in another video i read that atherosclerosis can even be present in infants, so it can be a heditary

[@ajharmiah2692]

I could be wrong but i think is the sitting position for long hours of the day, i understand you get up and do stuff, but still.

[@sueatkins3091]

I have severe claudification in both legs, was told to walk through the pain, my case would be reviewed in 6 months time,that was in July 2019 .....still waiting for my review, appears I’ve been forgotten about, has anybody else had this problem?

[@teresa985]

I think i have but i dont know. No Doc diagnosed still. How did they diagnose you?

[@indirakushwaha2636]

@@teresa985 ya I think also

[@teresa985]

@@indirakushwaha2636 Why you think so?

[@indirakushwaha2636]

@@teresa985 because me leg have pain from left side and I feel like मेरी नस दुख रही है उनके ऊपर से नीचे तक दुखती है

[@teresa985]

@@indirakushwaha2636 🤔 what? 🙄

[@kurtslavain]

Treatment? I don't care about treatment. I want to reverse it.

[@kalebdodson8382]

They don’t want to help reverse it. They want to make money off you, aka treatment.

[@STONE69_]

They can't reverse this now, its permanent. Low fat, sugar, salt, diet and walk every day.

[@kurtslavain]

@@STONE69_ So I'm not interested. F that. Thankfully, turned out I don't have it but if I did, I wouldn't settle for the half a life you're all ok with, for some reason.

[@STONE69_]

@@kurtslavain what half a life, lets say you did have it, and they put stents in you, they will eventually get blocked. then what?? prevention is the best method.

[@kurtslavain]

@@STONE69_ If I did have it, my life is already over and I have nothing left to do but wait to die or whatever. Half a life not worth living. Sorry old f***s. I have a different idea of fulfilling life.

[@allenlee466]

keep taking my blood thinners I just got out the hospital and I stop taking my blood thinners and now I have this burning pain in my right thigh

[@Alilamedicalmedia]

Go to hospital, you may have a blood clot.

[@rambobrazy8411]

@@Alilamedicalmedia ive been having pain in my left thigh for 4 years🤔

[@krishkarthick90]

Im 32 i have this problem pls give some solution im smoker

[@lilfreddygaming1347]

Who disliked the video wtf

[@kassrripples3659]

What about white clots? A new pathophysiology?

[@deshawnreding9575]

Some one give me advice or help me i dont wanna die young please someone help me

[@veganfortheanimals6994]

what's your question

[@lizmarty8937]

Stop thinking about dying and start living you have your whole life ahead of you. Your alive now. So many people would like to be living longer to do things and be with people they love. Your alive , make a positive difference by doing something that makes you and others happy maybe a job , education, career or volunteering. Good luck 😊

[@deshawnreding9575]

@@veganfortheanimals6994 i have this exact disease and im only 18😔😔idk what to do I haven’t even got to live yet

[@deshawnreding9575]

@@lizmarty8937 i have this exact disease and im only 18😔😔idk what to do I haven’t even got to live yet

[@Fargosportsmassage]

Me too..i thought it was pad but it was herniated sciatic pinching nerve..it is all about stop eating procesed food..eat only organic..meat every kind but very small proporciones..only olive extra oil..pure ..no sugar..lost water or fruits juice blender..pure sugar cane it is $ 2 more expensive but worthy

[@sandeepanchan3436]

Iam 46 aged men.i am over weight. Can't lose weight because exercise and walking make my legs worse stiffness.cant sleep on sides.😭

[@elizabethwoolnough4358]

Could you swim?

[@sandeepanchan3436]

@@elizabethwoolnough4358 thanks for your reply mam.i have not tried recently.but the problem is we are in remote area.swimming pool is more than 20kms far from me.

[@sandeepanchan3436]

I am staying in India

[@teresa985]

@@sandeepanchan3436 Slowly slowly you should start walking and continue to walk. You should not start with brisk walk in the beginning itself. Walk in such a way you dont feel really very tired.

[@carlalattanzi6873]

Eat a plant based diet without dairy and meat and the weight will come off

[@dhillonamarsingh5033]

Kindly advice how to remove plagues in vessels of legs 🦵Thanks

[@carlalattanzi6873]

Look up pomegranate juice 🥤 to clean plaque out of arteries. They did studies on how it cleans out carotid arteries. But you’ll need to follow a plant based diet afterwards to maintain and not fill arteries and blood vessels back up. Kale and dark leafy greens reduce inflammation but there’s something in pomegranate juice that works. Research the best brand of pomegranate juice

[@ankitraghuvanshi5514]

Dhillon sahab kindly contact me...