Claudication/Rest Pain/Ulcer/Gangrene [Legs/Arms]

Claudication is pain or cramping in the lower legs when walking which subsides with rest. It is due to inadequate blood supply to the muscles.

Rest pain is a severe pain which occurs in the lower legs when blocked arteries do not allow enough blood flow and oxygen supply to the legs. This pain occurs even when at rest. Rest pain can occur in other areas such as the arm.

Ulcers occur when there isn't adequate blood flow to an area. The skin breaks down and an open area develops.

Gangrene occurs when there isn't adequate blood flow to the tissues of the extremity. As the lack of blood flow progresses, the area may not heal and the skin can breakdown. The tissue becomes a black color and dies.

Signs & Symptoms

Lack of hair growth on your legs or arms

A wound that won't heal

Shiny, thin skin on your legs

Black, dead tissue on your legs or arms

Numbness, heaviness or pain in your legs when you walk or are at rest

Difficulty walking

Impotence

Change in skin temperature (coldness)

Severe leg pain not relieved by rest

Thick toe nails

Skin breakdown/open area on the skin

Black/foul smelling skin on ulcers

Diagnosis

Physician's Examination A health care provider investigates the body of a patient for signs of disease. It generally follows the taking of the medical history - an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.

Pulse Volume Recording Test (PVR)  A test which uses inflated blood pressure cuffs placed at the thigh, calf, ankle and toes to measure waveforms which give the physician information about blood flow in that limb.

Ankle-Brachial Index (ABI) A blood pressure reading which is taken in at the ankle and arms and compared to determine if a person is at risk for peripheral vascular disease.

CT Angiography Computerized tomographic angiography is a minimally invasive test which combines a CT scan (X-rays and computerized images) and angiography to show detailed images of the blood vessels in the body.

Angiogram An X-Ray study of the arteries. An IV dye (Contrast) is used to enhance the arteries so that they can be seen under X-ray imaging.

Magnetic Resonance
Angiogram (MRA) Magnetic Resonance Angiogram is a minimally invasive test that helps physicians diagnose and treat medical problems. MRA uses magnetic field and radio waves to take pictures of the major blood vessels throughout the body. Sometimes contrast material is used to enhance the blood vessels. Both blood flow and the condition of the blood vessel wall can be seen.

Treatment

Medication

Stop Smoking

Lower your cholesterol blood level

Keep your Diabetes under control

Keep your blood pressure under control

Exercise regularly

Angiography with balloon angioplasty and/or stenting

Bypass surgery or endarterectomy surgery

Hyperberic oxygen chamber

Meticulous wound care

Amputation