Brownwood News (by Mike Blagg)

On Thursday December 5, Dr. Ernesto Rivera presented a lecture on Peripheral Arterial Disease at the Brownwood Regional Medical Center conference room.  Dr. Rivera is a cardiologist who specializes in peripheral vascular diseases.

Peripheral Arterial Disease is a condition where plaque builds up on the inside wall of the arteries that carry blood from the heart to the legs and arms.  The arteries harden and narrow (atherosclerosis) and blood flow to the legs and feet is significantly reduced.  PAD may also involve hardened and narrowed arteries to the heart and brain, causing an increased risk of heart attack or stroke.

Many individuals with PAD may be unaware of it, but noticeable symptoms include pain in the legs and limited mobility. The most severe form of PAD is called Critical Limb Ischemia, which is a chronic and severe restriction of blood flow to the limbs.  CLI leads to reduced tissue resilience, impeded wound healing, and rapid tissue necrosis (death of cell tissue).

Risk factors for PAD include:

***  High blood pressure

***  Tobacco usage

***  High cholesterol

*** Family history of the disease

***  Diabetes (Diabetics are five times more likely to suffer from PAD)

Each year there are more than 160,000 amputations performed in the U.S. as a result of PAD.  Many of these could be prevented with early detection and proactive care.  The amputation rate among patients with CLI, the worst form of PAD, is estimated to be around 25%.     Patients with an amputation have a 50% mortality rate within five years.

Symptoms that you have PAD include:

***  Tiredness, heaviness, or cramping in the leg muscles

***  Toes or feet that look pale, discolored, or blue

***  Leg or foot pain while sleeping

***  Sores or wounds on toes, feet, or legs that heal slowly or not at all

***  A leg or foot that feels colder than the other

***  Thick, yellow toenails that are not growing

A simple test for PAD is called Ankle Brachial Index (ABI), and can be performed by your primary care physician during your annual physical.  It involves taking a blood pressure reading on both your arm and a leg.  The pressure reading should be almost the same.  If the pressure reading on your leg is less than 90% of the reading on your arm, that is a sign of possible PAD.  An ultrasound test can then look for possible narrowing of the arteries or blockages in the legs.

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There is a correlation between PAD and heart disease.  Heart disease is often discovered after first diagnosing PAD.

For more information on Peripheral Arterial Disease contact Dr. Ernesto Rivera at 125 South Park Dr., Suite A, Brownwood, TX.  His office telephone is 325-641-8648.