Peripheral Arterial Disease

Definition:

Although atherosclerosis affects all of the arteries of the body by narrowing them—like furring of water pipes—and making them more susceptible to rupture the term peripheral arterial disease is usually only applied to the arteries of the lower limb. 

Cause and scope for prevention:

Atherosclerosis, a systemic disease affecting all arteries, any programmes designed to ‘prevent heart disease’ are focused on the prevention of atherosclerosis. To prevent atherosclerosis of the lower limbs it seems that the single most important step is stopping smoking, although all the risk factors have to be tackled.

Diagnosis:

The disease is usually diagnosed by the very typical history of the person, almost always a man having to stop because of pain in the calf muscles. This is called intermittent claudication , named after Claudius who famously had a limp. The pain is relieved by a few minutes rest but the person has to stand still, perhaps looking in a shop window until it goes. 

Diagnosis is confirmed by arteriography. 

Standard medical therapy:

Vasodilators may be prescribed but the key intervention has been surgical, by passing the blocked sections of the arteries. However, the recognition that exercise could improve symptoms significantly means that exercise therapy is now the first line of treatment.

Benefit of exercise therapy:

The benefit, like from all types of exercise designed to improve stamina is probably to increase the efficiency with which the muscle cells remove oxygen from the arterial blood that reaches them.