- Plaque buildup in the arteries(called atherosclerosis) that carry blood to your head, organs, and limbs.
- Plaque is made up of fat, cholesterol, calcium, fibrous tissue that can harden and narrow the arteries.
- Limits the flow of oxygen-rich blood from your heart to your hands, legs, head, kidneys, and stomach.
- Here we will here focus on P.A.D. that affects blood flow to the hands.
- Less common than Lower Limb Disease due to the arms’ closer proximity to the heart, and the fact that most patients are asymptomatic.
UPPER LIMB ISCHEMIA
- High amounts of certain fats and cholesterol in the blood.
- Tobacco usage in any form.
- High blood pressure.
- Inherent blood clotting issues.
- Old age.
- Thoracic Outlet syndrome.
- Raynauds syndrome.
- Eventually, a section of plaque can rupture (break open), causing a blood clot to form at the site.
- Acute- Sudden block of the blood vessels causing an immediate threat to the hand.
- High risk of amputation.
- Needs urgent treatment.
- Chronic- Gradual decrease in blood flow.
- Needs treatment of the underlying cause.
ASSOCIATED HEALTH ISSUES
P.A.D. increases your risk of coronary heart disease, heart attack, stroke, and transient ischemic attack (“mini-stroke”).
- Weak or absent pulses in the hands.
- Intermittent Claudication symptoms when using the arms and forearms for work may include pain, numbness, aching, or heaviness in the muscles. Symptoms also may include cramping in the affected side.
- Pain in the fingertips even at rest.
- Sores or wounds on the fingers that heal slowly, poorly, or not at all.
- Gangrene (tissue death)- black color change of skin and tissue.
- Infected wounds.
- A pale or bluish color to the skin.
- A lower temperature in one hand compared to the other hand.
- Doppler Ultrasound.
- Stress position tests.
- X-rays of the neck to see bony abnormalities.
- Computerized Tomographic Angiogram (CT Scan).
- Magnetic Resonance Angiogram (MRI Scan)
- Treatment is based on your signs and symptoms, risk factors, and the results of physical exams and tests.
- Overall goals- improving symptoms and quality of life, reducing symptoms of claudication, reducing infection, healing wounds, reducing the risk of heart attack, kidney failure, and stroke.
- The target of treatment in Claudicants- improve pain-free period.
- The target of treatment in individuals with wounds/gangrene- remove dead tissue, heal the wound and preserve healthy tissue.
Healthy Lifestyle Changes
- Physical activity
- Quitting smoking
- Heart-healthy eating
Bypass Grafting/Embolectomy Surgery- open surgery.
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