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Who Knows?

Posted by john h on 2/27/04 at 11:32 (145512)

I am at my office and do not have the Mayo Health Clinc news in front of me but will mention an article in the current issue.

There is a disease which can cause pain in the calves,legs,and/or feet. The pain can be dull, aching, or sharp. Getting off your feet can help but it can progress to a point where it even hurts when you lay down. I do not remember the name of this disease but will post it tonight. Something like 25% of people over 50 can have it and 75% go undiagnosed. The pain is caused when the artteries in the legs narrow. In order to compensate for this, small new blood vessels form to let the blood pass. However, when you over do with fast walking,etc the small vessels cannot handle the blood flow and results in pain at various places which can be anywhere in the feet. One way to test for this is to take your blood pressure on your arm and then take the blood pressure at your ankle. The Mayo letter then has a formula to compare these readings and give you some idea if you might suffer from this disease. It is more common in people who are over weight,have high chloesterol or blood pressure or diabetes. Other symptoms can be cold or hot feet and it actullay can lead to an amputation in. extreme cases. Probably not applicable to most people here but then taking your blood pressure at your ankle and arm is an easy thing to do.

Re: Who Knows?

Linda L on 2/28/04 at 00:10 (145557)

And whats the difference of blood pressure between leg and arm? would the leg have al ower blood pressure if it was affected?

Re: Who Knows?

Dorothy on 2/28/04 at 03:54 (145561)

John H ~ Is it Peripheral Arterial Occlusive Disease? (PAOD) or is it Intermittent Claudication? These are two possibilities from your description.

Re: Who Knows?

Dorothy on 2/28/04 at 04:04 (145562)

Linda: I think the answer to your question is toward the end of this information.

Peripheral vascular disease; PVD; Peripheral arterial disease; PAD; Arteriosclerosis obliterans
Definition Return to top

Arteriosclerosis of the extremities is a disease of the blood vessels characterized by narrowing and hardening of the arteries that supply the legs and feet. This causes a decrease in blood flow that can injure nerves and other tissues.
Causes, incidence, and risk factors Return to top

Arteriosclerosis, or 'hardening of the arteries,' commonly shows its effects first in the legs and feet. The narrowing of the arteries may progress to total closure (occlusion) of the vessel. The vessel walls become less elastic and cannot dilate to allow greater blood flow when needed (such as during exercise). Calcium deposits in the walls of the arteries contribute to the narrowing and stiffness. The effects of these deposits may be seen on ordinary X-rays.

This is a common disorder, usually affecting men over 50 years old. People are at higher risk if they have a personal or family history of coronary artery disease (heart disease) or cerebrovascular disease (stroke), diabetes, smoking, hypertension, or kidney disease involving hemodialysis.

Symptoms Return to top

Often, symptoms affect one limb. If arteriosclerosis exists in both limbs, the intensity is usually different in each.
Leg pain (intermittent claudication)
Occurs with exercise (such as walking)
Relieved with rest
Numbness of the legs or feet at rest
Cold legs or feet
Muscle pain in the thighs, calves, or feet
Loss of hair on the legs and/or feet
Change of color of the legs
Paleness or blueness (cyanosis)
Pulse, weak or absent in the limb
Walking/gait abnormalities
Signs and tests Return to top

An examination may show arterial bruits (whooshing sound heard with the stethoscope over the artery), decreased or absent pulse in the extremities, or decreased blood pressure in the affected limb.

Re: Who Knows?

Julie on 2/28/04 at 06:36 (145566)

It sounded like intermittent claudication to me, Dorothy - my husband has it. There are various causes - narrowing of the arteries in the legs, as John describes; spinal stenosis (narrowing of the channel putting pressure on nerves) is another.
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Re: Who Knows?

Julie on 2/28/04 at 06:54 (145567)

Clarification: my post above was a response to Dorothy's response to John, in which she suggested two possibilities for the identification of the condition John described. I wasn't suggesting that intermittent claudication is Linda's problem.

The way the posts appear in a thread doesn't make it clear which post each response is in response to, which can be misleading.
.

Re: Who Knows?

john h on 2/28/04 at 17:41 (145611)

Dorothy it is indeed Peripheral Arterial Disease (PAD). The pain occurs most often in the calves but can occur in the buttocks,hips,thighs, or feet. As the PAD progresses, pain may occur when lying down.

Divided the systiloc blood pressure reading in your ankle by the systolic pressure in your arm to find your ankle-brachial index (ABI). A reading of 1 - 1.4 often incicates normal. A reading of .4 - 1.2 often indicates intermittent claudication. A reading of .2 - .6 often incdicates pain at rest. 0 -.4 often indicates impending gangrene.