Dr. Ashok Mittal, Cardiovascular Specialist with Miami Cardiac and Vascular Institute, explains the difference between arteriosclerosis and atherosclerosis. "Arteriosclerosis is the hardening of the blood vessels and atherosclerosis is one of the causes of the arteriosclerosis. The other causes of arteriosclerosis could be inflammation, vasculitis, and inflammation of the blood vessels." He also says people who have high cholesterol are at increased risk of suffering from atherosclerosis, because they have more fat flowing in the blood vessels and if they have inflamed arteries, more deposition of fat will happen.
Peripheral Artery Disease (P.A.D) can be diagnosed with an ankle-brachial index, an angiography, a doppler ultrasound, a treadmill exercise test, and a physical exam. Dr. Ashok Mittal, Cardiovascular Specialist with Miami Cardiac and Vascular Institute, explains doctors start with a physical exam to check the pulses in the patients' legs. "If I feel the diminished pulses or even if I don't, but they still have the symptoms, I can send them for ankle-brachial index to check the blood pressure of arms and legs."
Dr. Ashok Mittal, Cardiovascular Specialist with Miami Cardiac and Vascular Institute, explains diabetes is a risk factor of Peripheral Artery Disease (P.A.D), because it is an inflammatory condition. "Insulin resistance leads to the deposition of fat inside the muscle, the muscle cannot take up glucose, which builds up in the blood, and that causes decrease in the blood flow as well as inflammation, and arteries which are inflamed are more prone to atherosclerosis." He points out obesity is a serious matter to take care of because it is not only fat, it is a pro-inflammatory state of the body.
Treatments for Peripheral Artery Disease (P.A.D) can include lifestyle modification, treatment of existing conditions, statin, antiplatelet therapy, angioplasty, and vascular surgery. "Usually we start with medical therapy that includes use of aspirin, which is an antiplatelet agent. We also use statins, which are medications to decrease the bad cholesterol," says Dr. Ashok Mittal, Cardiovascular Specialist with Miami Cardiac and Vascular Institute.
Peripheral Artery Disease (P.A.D) can be asymptomatic, but it is still a problem; symptomatic, also called claudication, where patients have pain when walking, typically in calves; and Critical Limb Ischemia, where patients present tissue loss and they are at high risk for amputation. Dr. Ashok Mittal, Cardiovascular Specialist with Miami Cardiac and Vascular Institute, explains at rest people do not need increase of the blood flow, but when they are walking, the muscles need more blood and if there is narrowing of the arteries the blood flow cannot increase according to the demand of the muscle and that is why people feel pain.