Extremity Pain Due To Pvd
eripheral vascular disease (PVD), commonly referred to as peripheral arterial disease (PAD) or peripheral
artery occlusive disease (PAOD), refers to the obstruction of large arteries not within the coronary, aortic
arch vasculature, or brain. PVD can result from atherosclerosis, inflammatory processes leading to stenosis,
an embolism, or thrombus formation. It causes either acute or chronic ischemia (lack of blood supply). Often
PAD is a term used to refer to atherosclerotic blockages found in the lower extremity.
PVD also includes a subset of diseases classified as microvascular diseases resulting from episodal narrowing
of the arteries (Raynaud's phenomenon), or widening thereof (erythromelalgia), i.e. vascular spasms.
Claudication - pain, weakness, numbness, or cramping in muscles due to decreased blood flow
Sores, wounds, or ulcers that heal slowly or not at all
Noticeable change in color (blueness or paleness) or temperature (coolness) when compared to the other limb (termed unilateral
dependent rubor; when both limbs are affected this is termed bilateral dependent rubor)
Diminished hair and nail growth on affected limb and digits.
Smoking - tobacco use in any form is the single most important modifiable cause of PVD internationally.
Smokers have up to a tenfold increase in relative risk for PVD in a dose-related effect.
Exposure to second-hand smoke from environmental exposure has also been shown to promote changes in blood
vessel lining (endothelium) which is a precursor to atherosclerosis.
Diabetes mellitus - causes between two and four times increased risk of PVD by causing endothelial and smooth
muscle cell dysfunction in peripheral arteries. Diabetics account for up to 70% of nontraumatic
amputations performed, and a known diabetic who smokes runs an approximately 30% risk of amputation within 5 years.