Peripheral vascular disease

Peripheral vascular disease (PVD) is a chronic disease causing your blood vessels to become partly or completely blocked. This affects the blood flow in both arteries and veins, making it difficult for blood to circulate.

PVD includes 2 diseases:

• peripheral artery disease — which blocks blood flow in your arteries
• venous disease — where the blocked blood flow affects your veins

PVD most often narrows the arteries in your legs and feet. Treatment is important to manage the condition and prevent complications.

Some people may not show any symptoms. This is the mildest form of PVD. Others may develop serious issues such as ulcers or numbness.

Moderate symptoms

The most common symptom is painful cramping in your leg muscles. This is triggered by physical activity such as walking or climbing stairs. The pain usually goes away when you rest your legs. This type of pain is known as 'intermittent claudication'.

Other moderate symptoms include:

• coldness in your lower legs or feet
• missing pulses in your legs or feet
• hair loss on your legs and feet
• brittle and slow-growing toenails

Severe symptoms

If the blockage is severe, you may have pain in your legs even when resting. This pain can be severe and often happens at night. Hanging your legs over the edge of your bed may ease the pain.

Other severe symptoms include:

• your foot looking blue and dusky
• your foot turning pale when raised and red when sitting
• ulcers (open sores) on your feet and legs that don't heal
• gangrene (dead tissue)

During a sudden shortage of blood to your limb and foot, you may experience:

• a white or cold limb
• no pulse in your limb
• limb pain, numbness or tingling
• limb paralysis

PVD is caused by a build-up of fatty plaques in the walls of your arteries. This makes the arteries narrower and restricts the flow of blood to the part of the body affected. This process is called 'atherosclerosis'.

Several factors can contribute to narrowing of arteries, including:

• smoking
• high blood pressure
• diabetes
• high cholesterol and triglycerides (a type of fat)
• getting older
• family history of cardiovascular disease

If you have leg pain that comes on when walking and gets better when you rest, see your doctor. Also see your doctor if you notice any other moderate symptoms.

Seek urgent medical care if you have any severe symptoms. These symptoms may suggest that the supply of blood to your legs has become severely restricted.

To diagnose PVD your doctor may:

• check your medical history — they will look for factors that may increase your risk of PVD
• ask about your symptoms — for example, if you have leg pain when walking
• perform a physical examination — they will feel for pulses in your legs and check for symptoms such as shiny or pale skin

They may also refer you for tests such as:

• ankle-brachial index (ABI) — this compares the blood pressure in your legs to the blood pressure in your arms
• an ultrasound scan — to measure the blood flow in your legs and find narrowed or blocked areas
• CT or MRI angiography — where dye is injected into your blood vessels during a CT scan or MRI scan. This provides detailed images of your blood vessels to see how severe and where the blockages are.
• blood tests — such as a cholesterol test or a diabetes test

Your doctor may also refer you to a specialist such as a vascular surgeon.

Lifestyle changes

Treatment involves lifestyle changes, medicine and sometimes surgery.

Medicines

Taking medicines can address the underlying cause of PVD. It can also reduce your risk of developing cardiovascular disease. Your doctor may recommend you take:

• statins — a type of medicine that lowers cholesterol levels
• blood pressure medicines — to control blood pressure
• blood thinners — to prevent blood clots
• diabetes medicines — to control your blood sugar levels if you have diabetes
• pain-relief medicines — to reduce leg pain and improve walking distance

Surgery

Surgery may be needed if you have severe symptoms. Possible procedures include:

• angioplasty — using a balloon to open the blockage and improve your blood flow
• inserting a stent — using a metal device to keep your artery open
• bypass graft — to bypass longer blockages. This involves using a plastic tube or a vein from the leg to bypass the blockage.

Making lifestyle changes may help improve your symptoms and reduce the risk of complications.

PVD can lead to serious complications, such as:

• heart problems
• stroke
• deep vein thrombosis — clots in deep veins, usually in the legs
• ulcers — sores on your legs and feet that don't heal properly
• gangrene — this is where part of your limb loses its blood supply and dies
• amputation — in severe situations, poor blood flow to your limb requires the removal of a limb
• erectile dysfunction

You can help prevent PVD from developing or getting worse by adopting a healthy lifestyle:

• Quit smoking, if you smoke.
• Get some regular exercise.
• Maintain a healthy weight.

You can also help to prevent PVD by controlling other health conditions:

• Make sure to check and control your blood glucose levels if you have diabetes.
• Monitor and maintain healthy blood pressure levels.
• Keep your blood cholesterol and triglyceride levels within healthy ranges.

Heart Foundation (Opens in new tab) offers information on conditions affecting your heart and blood vessels.

For help quitting smoking, visit Quit (Opens in new tab) or call the Quitline on 13 7848.

The Department of Health, Disability and Ageing offers a list of resources to help manage chronic conditions (Opens in new tab).

You can also call the healthdirect helpline on 1800 022 222. A registered nurse is available 24 hours a day, 7 days a week.

Looking for information for Aboriginal and/or Torres Strait Islander people?

HealthInfoNet (Opens in new tab) provides advice on cardiovascular health for the Aboriginal and Torres Strait Islander community.

Looking for information on living with disability?

Limbs 4 Life (Opens in new tab) offers support and information on prosthetics and recovery for people who have had an amputation.