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
• Pulses
• Major arteries (for abnormal noises)
• Heart and lungs
• Neurologic exam (reflexes and sensation in your legs)
• Muscles (looking for atrophy in leg muscles)
• Skin

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)