These symptoms are never an emergency. This is plaque in the arteries, so it's not like anyone needs to rush to the emergency room. But they should mention the symptoms to their doctor so that their doctor can assess them.
How is PAD diagnosed?
The simplest way is with an ankle-brachial index. You put blood-pressure cuffs on both arms and both ankles and listen to the pulse and measure the ratio of blood pressure in the ankles compared to that in the arm. That is pretty much diagnostic.
What is the treatment for PAD?
My specialty is noninvasive treatment of vascular disease. Basically, we start with risk-factor modification: Treat the diabetes, stop smoking, treat high blood pressure, take aspirin or other blood thinner and exercise. Anyone with PAD should do those things. It is basically the medical management of all the things that cause the blockages.
Exercise is by far the most effective treatment, but it should be supervised. At Hopkins, the patients come to a center three times a week and are monitored on a treadmill. Usually, people can double the distance they can walk by the end of 12 weeks.
Is there new research that might affect treatment of blockages of the arteries?
At Hopkins, we are one of the sites for a National Heart, Lung and Blood Institute study called the CLEVER [Claudication: Exercise Versus Endoluminal Revascularization] Trial. It is a multicenter trial comparing supervised exercise, endovascular stenting [balloon angioplasty followed by insertion of a wire-mesh tube to prop open the artery] and medical therapy for the treatment of PAD.
