Peripheral Artery Disease Living With

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PAD is a lifelong medical condition. Once you have been diagnosed with PAD, you will see a healthcare provider regularly who specializes in vascular (blood vessel) diseases. You will need to take steps to prevent complications. Learn more about the warning signs of a medical emergency related to PAD below.

PAD can lead to complications, such as the following:

• Trouble managing daily activities without help because of reduced mobility
• Chronic (long-term) poor blood flow in your leg: This is called critical limb ischemia and is another complication of PAD. Symptoms may include pain during rest, sores, infections, and death of tissue, called gangrene, because of lack of blood flow. Gangrene is a severe complication that may require amputation (surgical removal) of the affected body part.
• Serious infections: These can develop as a result of sores on your feet that then get infected. Infections in the foot can usually be treated with antibiotics, but you may have to be treated in the hospital if the infection is serious. The infection can also spread to your tissues and muscles, to the bone, or into the bloodstream. Infections in the bloodstream need to be treated right away in the hospital. The risk of these complications is higher for people who have PAD and diabetes.
• A sudden drop in blood flow to your leg: This is called acute limb ischemia and is a serious medical emergency. Call 9-1-1 or seek medical help right away if you suddenly lose feeling in your foot and cannot move it and if it is blue or paler and colder than the other foot. Quick treatment may save your limb.

People who smoke or have diabetes have a much higher risk of complications from PAD, including the risk of losing a limb. Lower your risk by quitting smoking and managing your diabetes.

If you have PAD, you probably have plaque buildup in your other arteries, including arteries in your heart and brain. Over time, plaque buildup can lead to coronary heart disease, heart attack, or stroke. If you have PAD, talk to your healthcare provider about ways to lower your risk of these conditions.

It is important to get routine medical care and to take all medicines as your provider prescribes them.

• Talk with your provider about how often you should schedule office visits and blood tests or other tests.
• Call your provider’s office between visits if you start to have leg pain that does not go away after a few minutes of rest or if any other PAD symptoms get worse. Changes in symptoms could be a sign of PAD complications.
• Get recommended vaccines, including the pneumococcus and influenza (flu) shots, every year at the start of flu season. Anyone who lives with you or whom you see often should also get regular vaccines.

Follow up with your doctor regularly to check your risk factors, monitor symptoms, and assess your legs and feet.

Foot problems are a common complication of PAD. If you develop a foot sore, you’ll need regular care to help the sore heal and prevent infection.

Many people who have PAD also have diabetes, which raises the risk of complications that may lead to amputation, a surgery to remove all or part of a foot or leg. Diabetes may also cause nerve problems that make it hard to sense when you have injured your feet.

You can reduce your risk for foot ulcers and infections by taking care of your feet in the following ways:

• Always wear socks and shoes. Socks should not have any seams. Wear comfortable shoes that fit well and protect your feet. Your shoes should have low heels and shock-absorbing soles to reduce pressure on the bottom of your foot. Your provider may recommend that you visit a specialist who can modify your shoes to reduce your chance of getting sores on your feet.
• Check your feet every day for injuries or sores. If you have PAD and diabetes, have your doctor examine your feet twice a year.
• Do not go barefoot. This will help prevent foot injury that can lead to ulcers and infections, which are more likely when you have poor circulation.
• Follow your provider’s instructions about caring for incisions or cuts made in your skin during surgery or procedures to treat PAD.
• See your provider for any foot problems. To avoid injuries that could lead to sores or infections, do not treat corns, calluses, long or ingrown nails, or other foot problems yourself. 

Some conditions during pregnancy, such as preeclampsia, a high-blood pressure disorder, or gestational diabetes, high blood sugar during pregnancy, can raise a woman’s risk of developing PAD later in life. 

PAD symptoms may be worse for women than for men. Women who have PAD often cannot walk as far or as fast as men who have PAD. They also report lower quality of life than men do, possibly because walking and other daily activities are hard. Depression is also more common in women with PAD than it is in men with the same disease.

People who have PAD often have lifestyle habits and other factors, such as family history, that make it more likely they have developed or will develop other diseases related to atherosclerosis. Those diseases may include:

• Coronary heart disease, when plaque builds up in the arteries of the heart
• Diseases that affect the arteries of the brain, including stroke and vascular dementia
• Heart attack
• Carotid artery disease, which affects the arteries in the neck
• Atrial fibrillation, a type of irregular heart rhythm or arrythmia
• Heart failure
• Chronic kidney disease
• Sleep apnea

If you have PAD with symptoms, your provider may want to use ultrasound to screen you for abdominal aortic aneurysm.

Control your blood pressure

If you have high blood pressure, there are some steps you can take to prevent or delay complications caused by high blood pressure:

• Follow your treatment plan.
• Get regular follow-up care.
• Learn how to monitor your condition at home.
• Tell your provider if you are planning to become pregnant. They may adjust your treatment plan as needed to lower or control your high blood pressure.

Follow your diabetes care plan

If you have diabetes, your provider will recommend lifestyle changes, including a special eating plan, and may prescribe medicines to manage blood sugar levels. Managing diabetes carefully can lower your risk of complications.

Be alert for sores on your feet or legs and call your provider if you see signs of an infection, such as redness, swelling, pain, or pus, or if you have a fever or chills. To treat sores, your provider may prescribe antibiotics, clean the sores, remove dead tissue with surgery, and apply medicines and bandages to the area.

Manage your blood cholesterol levels

If you have unhealthy levels of blood cholesterol, it is important that you continue your treatment. Follow-up care depends on your cholesterol levels, your risk of complications such as a heart attack or a stroke, and how you respond to treatment.

Living with PAD may cause fear, anxiety, depression, and stress. You may worry about having heart problems or making lifestyle changes that are necessary for your health. Some people become depressed because of problems with walking and taking part in daily activities. PAD might also lead to worry about the risk of amputation.

By lowering stress levels and learning coping skills, you may be able to live longer and improve your quality of life. Talk with your healthcare provider about how you feel. They may recommend you take some steps to help you manage stress, such as the following:

• Join a patient support group. Taking this step may help you adjust to living with PAD. You can find out how other people manage similar symptoms. Your provider may be able to recommend local support groups, or you can check with an area medical center.
• Seek support from family and friends. Letting your loved ones know how you feel and what they can do to help you can help relieve stress and anxiety.
• Talk to a professional counselor. If you have depression or anxiety, your provider may also recommend medicines or other treatments that can improve your quality of life.

PAD puts you at high risk of serious health problems. If you think that you are having symptoms of PAD, check with your provider. For the following conditions, call 9-1-1 right away. Every minute matters.

Acute limb ischemia

Acute limb ischemia is a medical emergency that must be treated rapidly to avoid amputation or other serious problems. Seek medical help right away if any of the following occur:

• You cannot feel or move your foot.
• Your leg or foot hurts or feels like “pins and needles” while resting.
• One foot is paler or colder than the other.

Bloodstream infection

When bacteria enter the blood from an infected sore, they can cause a bloodstream infection. Symptoms include fever and chills. Intravenous (IV) antibiotics need to be given right away in a hospital.

If a blood infection is not treated in time, or if the immune system can’t control the infection, the body’s  inflammatory  response can lead to septic shock, which is dangerously low blood pressure; organ failure; or even death.

Bone infections

If you develop deep ulcers over bones, you are at risk for a bone infection called osteomyelitis. Symptoms include bone pain; excessive sweating; fever and chills; swelling, redness, pain, and warmth at the site of infection; and an open wound that may show pus.

Treatment includes antibiotics, surgery to remove infected bone, and procedures to improve blood flow. You may need to stay in the hospital for treatment.

Cellulitis

Cellulitis is a skin infection that can spread to the deep tissues of the skin and muscle. Symptoms include areas of the skin that are warm, swollen, and tender. Cellulitis can also cause fever, chills, swollen lymph nodes, and blisters.

Your provider may prescribe antibiotics to take by mouth. If the infection gets worse or you get very sick, you may need to stay in the hospital for treatment.