Peripheral Vascular Disease
Questions to Discuss with Your Doctor:
- Do you develop pain, cramps, aches, fatigue, or numbness in your leg muscles when you walk?
- At what distance do you develop symptoms?
- Do they go away when you stop walking?
- Do you ever develop these symptoms at rest?
- Which leg muscles are involved?
- Do you have decreased sensation in your feet?
- If you are a man, do you have erectile dysfunction?
- Are you doing everything possible to modify the risk factors that can worsen this disease (smoking cessation, treating elevated blood pressure and cholesterol, and controlling diabetes)?
- Are you exercising regularly and at progressively more strenuous levels?
- Are you taking an aspirin every day?
- Are you eating a low-cholesterol diet?
- If you have diabetes, do you practice meticulous foot care (cleaning, applying moisturizing lotions, and wearing well-fitting protective shoes)?
- Do you know when to seek emergency medical care for peripheral vascular disease (if your leg becomes suddenly painful, pale, cold and numb)?
- Do you know when you should be referred to a vascular surgeon?
- Do you know possible surgical complications? (Be sure to ask how often the surgeon performs this operation).
- Do you get chest pain or pressure with exertion or at rest? If so, you may have coronary artery disease.
- Do you have sudden brief episodes of blindness (like a shade being pulled over your eyes) or sudden episodes of weakness in an arm or leg, or difficulty speaking? These could be warning symptoms of stroke.
- Do you get short of breath when you lie down or exert yourself?
- Do you awaken in the middle of the night short of breath?
- Do your ankles swell?
Your Doctor Might Examine the Following Body Structures or Functions:
- Heart rate, blood pressure, and weight
- Major arteries (for abnormal noises)
- Heart and lungs
- Neurologic exam (reflexes and sensation in your legs)
- Muscles (looking for atrophy in leg muscles)
Your Doctor Might Order the Following Lab Tests or Studies:
- Blood tests (glucose and cholesterol)
- Ultrasound (see p. 140)
- Doppler Ankle-Arm Indices
- Exercise Stress Test (see p. 660)
- MRI (see p. 143)
- Angiography (see p. 139)