Calf pain an ominous sign?

On walking a distance of only 100mts, Shah, a middle aged businessman complained of severe pain in both calves. Prescribed medications did not relieve the pain, which became more intense even while he rested. All these symptoms together with his habit of smoking and, most importantly, absence of pulsations in the leg, prompted his doctor — an interventional radiologist — to further investigate for Peripheral Arterial Disease (PAD).
A doppler test and angiography of the legs were advised to diagnose and treat the cause. The investigations revealed blockage of the arteries of the leg. The procedure successfully restored the blood flow in the leg, which not only relieved the symptoms, but also avoided an impending major amputation. Even as peripheral vascular disease (PVD) in the Indian populace is an alarming 8-10 per cent, awareness to manage the disease is dismal.
 
What is PAD?
The term peripheral arterial disease refers to damage or dysfunction within peripheral arteries. Peripheral arterial disease (PAD) is a common circulatory problem in which the arteries supplying blood to the limbs become clogged or partially blocked. Strictly speaking, PAD refers to a problem with any of the arteries supplying the legs. It is caused due to atherosclerosis, in which the arteries become hardened and narrowed. It is the same process which causes heart attacks.
PAD is a potentially fatal disease as it automatically puts patients at increased risk of heart attack, stroke and life-threatening abdominal aortic aneurysm (AAA).
If action is not taken at the right time, the patient may lose a limb or suffer a heart attack or stroke.
 
Symptoms

A primary cause for low awareness levels is that most people with PAD experience no symptoms, and by the time the problem is diagnosed, it is likely to be too late. Most people with PAD develop intermittent claudication. This condition is characterised by muscle pain or cramping in the legs or arms that is triggered by walking, but disappears after a few minutes of rest. Calf pain is most common. As PAD progresses, the arteries may become so clogged that pain may even occur when you’re not exercising or when you’re lying down and are at rest. This is called ischemic rest pain. The pain may be intense enough to prevent sleep or wake you from sleep.
 
Is PAD a treatable condition?

Treatment for PAD has two major goals:
1. To manage symptoms, such as leg pain, so that you can resume physical activities.
2. To stop the progression of PAD, to prevent gangrene or limb amputation.
Many people can accomplish these goals with lifestyle changes and drugs. In some cases, other interventions may be considered for intermittent claudication like angioplasty and stenting, and dissolving clots with drugs, or surgery.

How do I know if I am at risk of PAD?

Do you have aching; cramping or pain in your legs when you walk or exercise?
Do you have pain in your toes or feet at night?
Do you have any ulcers or sores on your feet or legs?
Do you smoke?
Are you overweight?
Do you have BP?
Do you have diabetes?
Do you have a family history of diabetes or cardiovascular problems or stroke ?
Do you have a sedentary lifestyle?

 If most of your responses to the above questions are ‘yes’, then you could be at the risk of PAD. It is important for you to see a doctor and investigate further.

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