What Does Leg Pain Have To Do with the Heart?

Recognizing and Treating Peripheral Artery Disease

Drew was just starting to cut back on his hours as a real estate development consultant and ease into retirement. An active grandfather and outdoor enthusiast, Drew and his wife were on a trip to Japan when a cramping sensation in his calves made it hard to keep up with their tour group. “I'd only walk the equivalent of a block or two,” Drew recalls. “Then, I had to stop and take some time to recuperate. It was very difficult.”

Upon returning home, Drew’s primary care provider referred him to the CardioVascular Institute at BIDMC. He was diagnosed with Peripheral Artery Disease, or PAD. One in 20 Americans over the age of 50 is living with PAD.

What is Peripheral Artery Disease?

PAD is a form of cardiovascular disease caused by plaque buildup in arteries. This buildup reduces blood flow to the arms or, most commonly, legs. A blockage in the leg can also be a sign that there might be a blockage in the heart and it increases the risk of stroke and heart attack.

“The risk of developing PAD increases with age and other conditions like hypertension and diabetes. Aging also causes stressors on the arteries,” explains Brett Carroll, MD, Medical Director of the BIDMC Vascular Medicine Program.

How to Treat Peripheral Artery Disease

Treatment plans can relieve PAD symptoms, improve quality of life, and reduce future health complications. There are many ways to treat and manage PAD and minimize risk factors.

Lifestyle Changes and Medications

PAD is a condition that requires ongoing medical attention. The good news is that patients can manage the symptoms and keep the disease from progressing with these lifestyle changes:

• Stopping the use of all tobacco products
• Eating a heart-healthy diet
• Maintaining an active lifestyle and exercising regularly
• Managing other chronic conditions such as diabetes, high cholesterol, and high blood pressure.

In addition to lifestyle changes, doctors often prescribe medications that decrease the risk of stroke and heart attack. These medications:

• Decrease symptoms of PAD
• Improve cholesterol
• Lower blood pressure
• Thin the blood to prevent clotting

PAD Supervised Exercise Therapy

Along with medication, our patient Drew benefited from supervised exercise therapy (SET). “What I learned in the program I continued to use. I can walk several miles at a time now without my legs bothering me.”

SET is a proven way for people with PAD to manage leg pain when exercising. The 12-week program consists of walking on a treadmill under the supervision of an exercise or physical therapist. Paid for by Medicare and most private insurances, SET helps the body use oxygen better and improves symptoms of PAD.

Interventional and Surgical Treatments for Peripheral Artery Disease

In some cases, medications and exercise alone are not enough to help patients with PAD. Minimally invasive procedures to repair and unblock the affected arteries are one option for some people. Interventional Cardiologists use imaging during procedures to see which areas require treatment. Next, they insert a very thin wire across the blockage and expand a balloon to open the artery. BIDMC physicians are also studying new devices coated with medication to help reduce blockages in patients with PAD. In some patients, surgical bypass treatments may be needed to improve blood flow, and the BIDMC Vascular Surgery PAD program is able to provide consultation regarding surgical care for PAD.

Start Here with the Show Me PAD Decision Aid

No one treatment plan fits every patient’s needs and lifestyle. We can help navigate treatment options with the Show Me PAD decision aid.

Eric Secemsky, MD, Director of Vascular Intervention in Interventional Cardiology at BIDMC, says that patients often come to him knowing little about PAD. “Our goal with this interactive tool is to empower patients to make decisions that are right for them.”

Dr. Secemsky received funding from the National Institutes of Health to promote this decision aid with help from fellow researchers. He adds, “The Show Me PAD Decision Aid is a unique tool. It educates and helps patients come to their own informed decision about their treatment. It allows us to offer individualized care.”

PAD Treatment at BIDMC

With our expertise and support, patients can return to an active lifestyle. Contact us today to be a part of our program. Call 617-667-8800 to schedule an appointment or email us.

Learn more about Vascular Medicine at BIDMC.
Related: PAD warning signs and symptoms in Pay Attention to Leg Pain.