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Category: PAD

Here’s What you Need to Know about Blood Clots

In our Houston vein practice, we know how serious a threat blood clots pose to your health. When we treat patients with Deep Vein Thrombosis (DVT), a condition in which blood clots form in the deep veins of your legs, we face a medical emergency. That’s because, if a blood clot breaks free and travels to other parts of your body—especially to your lungs—it can threaten your life.

But, many people want to know: why do I get blood clots? And, what are they exactly? Is there anything I can do to prevent them? So, in this post, we will try to answer all of those questions. Just keep reading to learn more.

Why do blood clots form? stages of PAD

When things are working properly, your blood flows freely through your body, delivering oxygen to your organs and flushing out the waste products created by your body’s metabolic processes. But, if you get a cut, scrape or injury, blood in your arteries and veins (veins return blood from the body to the heart; arteries transport blood away from your heart) will clot to block your blood vessels and stop you from bleeding out.

But, when your arteries or veins get blocked when you aren’t injured, you need medical intervention. Otherwise, you can face complications such as strokes, heart attacks, organ damage and even limb loss. In certain occasions, as we mentioned earlier, blood clots can kill you by travelling to your lungs (pulmonary embolism), interfering with your ability to breathe.

Blood clots form in blood vessels—either your deep veins or your arteries. Typically, they form after your blood vessels get damaged, triggering a reaction in your body. This reaction involves a mix of platelets and clotting factor proteins.

Why Do Blood Clots Cause Health Problems?

As we mentioned, problematic blood clots form when the connection between platelets and clotting factor proteins goes awry. Platelets are objects in your blood that group together and stick to the walls of your blood vessels when needed.

Clotting factors are proteins in the blood that trigger a reaction to makes platelets and red blood cells stick together. Typically, other proteins in your body make that reaction stop, so your clot only reaches the size needed to prevent excess bleeding.  But when damage to your blood vessels impacts that reaction, clots may grow unchecked, leaving you at risk for clotting conditions like DVT.

Why would I get an arterial blood clot or a DVT?

We can’t always predict who will be affected by blood clots, or when those clots will form. But we do know certain factors that can increase your risk for clots:

·         Prolonged immobility, as with long airplane flights

·         Arm or leg surgery

·         Casting a broken bone

·         Trauma

·         Smoking

·         Being pregnant

·         Diabetes

·         Obesity

·         High blood pressure

·         High cholesterol

·         Age

·         A family history of peripheral artery disease (PAD), stroke or heart disease or stroke

New research has revealed an additional risk factor for blood clots, and it’s one that you unfortunately can’t control. In fact, your blood type can contribute to that risk, according to a study published in the Journal Arteriosclerosis, Thrombosis, and Vascular Biology. 

The research, which began in 2017, found that people with types A or B blood had a combined 8% higher risk of heart attack, and a 10% increased risk of heart failure, as compared to people with type O blood. So, knowing your blood type could help you understand your risk for developing a blood clot. 20

Diagnosing and Treating Blood Clots

The best way to treat blood clots is to prevent their formation. Maintaining a healthy lifestyle, staying mobile even on long trips, and using compression therapy can all help protect you from DVT. Even if you develop a DVT, compression therapy—especially within 24 hours of the clot’s formation—can help manage your risk of further complications.

So, as with many other vein and arterial conditions, timeliness is key when it comes to treating blood clots. The sooner you see a vein specialist, the better the outcome you will likely enjoy.

 

Sources: American Heart Association

 

Got Leg Pain? It Could Be PAD

If you have unexplained leg pain, especially after you walk or exercise, you could be one of the eight to ten million people in the United States who suffer from Peripheral Artery Disease (PAD). This condition is often difficult to diagnose, leaving many sufferers untreated, which is a serious problem due to the danger that it can pose.

PAD symptomsWhat is PAD?

Peripheral Artery Disease is caused by a narrowing of the peripheral arteries. While it most commonly affects the legs, it can also be found in the stomach, arms, and even your head. Arteries begin to narrow when plaque, which is made up of cholesterol, calcium, fibrin, and fatty substances, builds on the walls of the artery. The disease restricts the amount of blood flow and raises blood pressure. In severe cases, a blood clot can form and completely stop your blood flow, which can result in a stroke or heart attack.

Risks & Symptoms of PAD

You could have PAD and not notice any symptoms until your disease progresses. Others may mistake their PAD symptoms for another condition. To avoid misdiagnoses and missed diagnoses, it is important to learn the most commonly observed symptoms of PAD. They include:

  • Leg pain during exercise, and also when at rest
  • Leg numbness or weakness
  • Wounds (ulcers) of the legs, foot, or toes that do not heal easily
  • Legs or feet that are cold to the touch
  • Slow nail growth on toes or lack of hair growth on the leg
  • Some men experience erectile dysfunction

Patients are more at risk for peripheral artery disease when they:

  • Smoke cigarettes
  • Have diabetes
  • Are obese
  • Have high blood pressure & cholesterol
  • Are over 50 years of age
  • Have a family history of heart issues or strokes

How is PAD Diagnosed?

Diagnosing peripheral artery disease is painless. And there are many ways to test for PAD, so your health care provider will perform a physical examination to determine which to choose. In addition, your doctor may perform:

Ankle Brachial Index: This compares the blood pressure in your feet to the blood pressure in the arms. It determines if your blood pressure is faltering in one area or throughout the body. Next, there are ultrasounds, which use sound waves to measure blood flow and visualize blockages in your arteries. Alternatively, you may need angiography: you’ll get a colored dye injection in your blood vessels. Then, we’ll trace the dye with an imaging device, so we can follow your blood path and determine where the problems lie. Finally, you may need blood tests to determine if your symptoms are the result of diabetes or other issues.

Sources: Mayoclinic.org

New Stem Cell Discovery May Help Cure Vein Disease

The world of vein treatments are constantly evolving, and it seems like every week there’s an exciting new discovery! Recently, Nature magazine revealed a new one: they’ve identified the stem cells responsible for growing new blood vessels in embryos. Why is that so exciting? If the cells can be studied and applied to adults, scientists could also grow healthy new blood vessels. And those vessels could repair or replace old, damaged ones.

New Veins Could Transform Circulatory Treatments

Vein disease sufferers will obviously benefit from newly-grown veins. But so will other people. In fact, this development would improve treatments for heart disease. It could also help manage circulatory conditions like peripheral arterial disease.

Until now, scientists thought that dividing endothelial cells created embryo blood vessels. But this new research proves that the opposite is true. In short, stems cells in the blood create and grow endothelial cells.

Of course,  we can’t yet grow new blood vessels. So we can’t yet apply this discovery to help treat vein disease. In order for that to happen, researchers will have to determine whether the stem cells can grow endothelial cells throughout life. Because there’s a chance this only happens during the embryo stage of development.

Moving Forward with Embryo Research

Unfortunately, we don’t yet have the methods necessary to track down these tiny stem cells in fully grown humans. And, even once those methods are developed, scientists will need to determine if the endothelial cells that come from these stem cells have their own functions. They will also need to figure out the best way to apply them for use in regenerative medicine.

Even with all the work that’s left to be done, the Associate Medical Director of the British Heart Foundation, Professor Metin Avkiran, is positive about the discovery. He says, “Using stem cells to treat patients with heart and circulatory disease has huge potential. But taking positive findings from the lab to patients has often been very challenging. These scientists have looked at how blood vessels develop in the embryo, and their findings have shed important new light on our understanding of the origin of growing blood vessels. Getting these fundamentals right is essential for finding stem cell treatments which will work in patients. These findings could pave the way to new discoveries in regenerative medicine and allow scientists in the future to grow new blood vessels and repair those that are damaged in many forms of heart and circulatory disease.”

Sources: University College London, Nature Magazine

Here’s One Smart Reason to Grab That Beer!

‘Tis the season to toast, and, as it turns out, that might not be such a bad thing after all. In fact, according to new research, picking up your wine glass or beer mug may have a very beneficial effect on your health. Especially when it comes to your risk of contracting certain circulatory conditions, including Peripheral Arterial Disease (PAD.)

How Wine and Beer Consumption Can Help Your Heart

Now, this information isn’t entirely new. We’ve all heard rumbles about how red wine—in moderation—is good for your heart. So what’s new about this research out of Cambridge and University College London (UCL)?

For one thing, the researchers are giving us updated quantities. Now, they recommend drinking about 1.5 bottles of wine each week, or seven  beers. But that’s not all the research suggests. As it turns out, drinking moderate amounts of alcohol is actually better than not drinking at all.

How did they reach this conclusion? Researchers analyzed data from close to 2 million United Kingdom residents. They discovered that avoiding alcohol and drinking a lot gave you a higher risk for seven different heart conditions. And those conditions include PAD, heart attacks and strokes.

Lead researcher Steven Bell explained that moderate alcohol intake reduces inflammation while boosting good cholesterol levels. Plus, moderate drinking can be social. And connecting with peers improves your overall well-being, including your heart health.

The Impact of Alcohol Avoidance

Now, researchers discovered the benefits of moderate drinking. But, they also found problems with avoiding alcohol completely. In fact, as compared to moderate drinkers, people with zero alcohol intake were more likely to experience angina, heart attacks, sudden coronary death, heart failure, strokes due to lack of blood flow, abdominal aneurysms and peripheral arterial disease.

There was, however, a silver-lining for sober people: not-drinking had no impact on the risk of experiencing cardiac arrest or strokes unrelated to blood flow problems. And, for those who have good reason to avoid alcohol, the researchers noted that alcohol isn’t the only path to decreased risk of heart problems. If you have a good reason not to drink (and there are plenty) you can improve your heart health and decrease your risk of disease with many other lifestyle factors, including diet and exercise. But, if you’re all about moderate, social drinking, take “heart” in these findings, which both Harvard Medical School and John Hopkins Public School of Health have signed off on. In fact, you could use this post to feel even better about the extra glass or two you’re bound to enjoy as you wind down the holiday season and ring in the New Year!

Sources: British Medical Journal (BMJ)

PAD vs. CVD: This is How You Tell the Difference

When you are experiencing leg pain, it can be difficult to know what’s causing your discomfort. That’s because two different conditions—Peripheral Arterial Disease (PAD) and Chronic Venous Disease (CVD) can make your legs hurt. So, how can you tell the difference between these problems? Just keep reading for our handy guide!

What is Peripheral Artery Disease?

PAD is a condition in which your arteries harden because of plaque build-up on the walls. This hardening narrows your arteries, making it more difficult for blood to flow through. And when this happens, you may experience symptoms in your legs, including: pain, numbness, or heaviness. These symptoms typically appear when you are active, and usually resolve when you rest.

What is Chronic Venous Disease?

Chronic Venous Disease is a way of describing conditions that develop when your veins aren’t functioning properly. These include varicose veins, ulcers, and edema. But, sometimes, venous disease shows up in less obvious ways. In fact, many symptoms of CVD are very similar to those associated with PAD. So, the question remains, how can you tell the difference between the two?

Ruling out PAD as a Diagnosis

Because PAD symptoms are so similar to those associated with CVD, it can be difficult to diagnose. But here’s the key factor to note when you talk to your doctor. When you have PAD, you will likely only experience symptoms like leg pain and heaviness when you are active. If you have Venous Disease, resting will likely not improve your symptoms. Also, when you have CVD, visible symptoms like spider veins will usually show up fairly quickly.

Finally, timing can be a major clue as well. With CVD, leg pain tends to show up at the end of a long day. Especially if you spent extended periods on your feet. But, with PAD, pain shows up day or night, and, as we mentioned, is typically tied to movement.

Of course, the easiest and best way to determine the cause of your leg pain is to see your vein specialist. But, clearly identifying your symptoms can help your healthcare provider quickly reach a diagnosis. So, take note of your symptoms and make an appointment today for a diagnostic ultrasound.

 

Sources: veinforum.org

Check Out What Happens to Your PAD Risk as you Age

Did you know that approximately one in five people over the age of 65 has peripheral arterial disease (PAD)? If that seems to you like a pretty high percentage, you’re right. And there’s a reason for that: as you get older, your risk for PAD increases dramatically. Here’s why.

What is PAD?

PAD is a condition you develop when plaque builds up in your arteries. What is plaque? It’s a substance in your blood that’s made up of fat, cholesterol and other substances. When it sticks to the walls of your arteries, they ‘harden’—that’s called atherosclerosis, and atherosclerosis interferes with your blood’s ability to flow.

When it’s the blood flow to your legs that’s impacted by plaque, we call that condition PAD. And PAD can lead to leg pain and numbness. The hair on your legs may fall out; your skin color may change. You may find that cuts and scrapes take longer to heal; some wounds will no longer heal on their own when you have PAD.

But PAD symptoms aren’t just experienced in your legs. When you have PAD, your risk of heart attack, blood clots and stroke also increases. So does your chances of losing a limb to amputation.

Why Does PAD Develop? stages of PAD

While the exact cause of this condition isn’t know, it seems to begin when the inner layers of your arteries get damaged: this damage could be the result of diet that’s high in fat and cholesterol; a lifestyle that includes smoking; diabetes; and/or high blood pressure. It seems that plaque builds up as your arteries begin to heal.

Unfortunately, PAD can be hard to diagnose. That’s because many people with this condition don’t show any symptoms. Or, they experience symptoms like leg pain, numbness, and cramping, but confuse these problems for normal signs of aging, or for signs of other medical problems. That’s why it’s important to know all the PAD symptoms, which include: sores that don’t heal well, bluish skin color, skin that’s cold to the touch; problems with toenail growth; and, in men, erectile dysfunction.

How is PAD Diagnosed?

If your vein specialist suspects you have PAD, you may need one or more of the following tests:

  • An ankle-brachial index (ABI), which determines your blood flow by comparing the blood pressure in your ankle to the pressure in your arm.
  • A Doppler ultrasound, which can detect blood vessel blockages with sound waves
  • A treadmill test, to detect whether leg cramps are associated with activity, and whether they resolve with rest

You may also need additional blood tests to check for related conditions like diabetes or high cholesterol.

Treating PAD

If you are diagnosed with PAD early on, you may be able to control your symptoms with a series of lifestyle changes. At our Houston area vein clinics, we also help PAD patients by using minimally invasive procedures. Some of the treatment options we offer include Angioplasty, Stenting, and Atherectomy—the procedure we recommend for you will depend on the location of your blockages and the progression of your disease.

But want to know what they all have in common? These methods will almost always spare you from having major, open surgeries. Because of that fact, your recovery period will be drastically reduced. And you will likely be discharged from hospital on the same day of your procedure.

Before we come up with your treatment plan, however, we need to conduct diagnostic exams. And, in order to do that, we need to see you in the office. So, if you suspect PAD may be behind your leg cramps, or if you have any other PAD symptoms, schedule a consultation right away.

 

Sources: Clinical Interventions in Aging

OMG: This is How Your Birth Month Determines the Way You’ll Die

Check out the discovery we’re calling the scariest of 2019. Late last year, that the time of year during which you were born can determine the way you die. More specifically, your birth month is directly linked to your odds of dying from heart disease! Want to know the worst birth months for heart health? Just keep reading!

Spring and Summer: The Seasons of Heart Disease

In a study published in The BMJ, researchers discovered that heart disease is more likely to kill you if you’re born from April to September, the spring and summer months.

Unfortunately, scientists can’t say exactly why these birth months increase your risk. But they do suggest that there’s a connection between your birth month, and your early exposure to seasonal dietary changes, available sunlight and air quality.

To reach these conclusions, they followed 116,911 women who were recruited for the study, and between the ages of 30 and 55 in 1976. Researchers examined the timing of their births, overall causes of death, and deaths caused specifically by heart disease.  Every two years, ending in 2014, the women completed health and lifestyle questionnaires.

By the end of the study period, over 43,000 of the women had died. And 8,360 of those women died of issues related to heart disease. While that figure may not seem so surprising, here’s what is: spring and summer babies were significantly more likely to have that cause of death when compared to their peers who were born in the fall. Still, without a direct causal link, the scientists warn us that this study is observation only. After all, they can’t completely rule out other, unmeasured factors that may contribute to the increased risk.  Still, if your birthday falls in this range—or even if it doesn’t—it’s important to learn the early warning signs of heart disease, so you can seek treatment at the first sign of a problem.

These are the Warning Signs for Heart Disease

Regardless of your risk for cardiovascular disease, you should never ignore these tell-tale symptoms, especially if they are sudden and unexplained:

1. Chest pain

2. Stomach pain

3. Sweating

4. Leg pain, especially when cramps appear with movement. This could be an early sign of of PAD (peripheral arterial disease).

5. Arm pain

6. Swollen ankles (edema), which can indicate circulatory problems or even heart failure.

7. Chronic exhaustion

On their own, any one of these symptoms should be a sign that it’s time to discuss your heart with a healthcare provider. But, in combination, consider these symptoms a potential emergency. Seek medical attention right away.

Sources: The BMJ, www.bmj.com

 

That Pain in Your Legs? It Could Mean a Blood Flow Problem

So many people are quick to brush off a little pain in your legs. But that tendency is the reason so many people with peripheral artery disease (PAD) have delayed or missed diagnoses.  You see, PAD is a condition that develops slowly and with few symptoms. Inside your body, your blood vessels are slowly narrowing due to atherosclerosis, a build-up of fatty deposits that keeps enough blood and oxygen from getting to your legs. And it’s that lack of oxygenated, nutrient-rich blood which can make your legs feel uncomfortable and crampy. Which in turn is why you should never ignore leg pain that appears for no apparent reason.

Now you know why ignoring leg pain can be so dangerous to your health. Next, let’s take a closer look at ways you can increase the flow of blood to your lower extremities.

This is How to Reduce PAD Symptoms with Improved Blood Flow

If you want to avoid PAD, or reduce existing symptoms, your best bet is to keep your arteries and blood vessels clear of blockages. You also need to work on improving your blood circulation.

The first step in this process? Get moving! Physical activity encourages blood flow. Plus, it helps you maintain a healthy weight, which can also help your body provide sufficient blood to your extremities.

Still, moving more isn’t enough. Diet is also a crucial part of preventing atherosclerosis, the “hardening of the arteries” that causes PAD. That’s because, through a healthy diet, many individuals may be able to lower their cholesterol levels. And high cholesterol is linked to the build-up of plaque in your arteries. (Keep in mind that some people may require medication to lower cholesterol levels. Discuss all changes to your diet with your healthcare provider.)

Regardless of whether or not you also need medication, people with PAD should focus on proper nutrition. As it turns out, many of the foods you eat can actually help improve your blood flow and boost the health of your veins and arteries. Top foods to try include:

·         Beets and beetroot juice

·         Onions

·         Garlic

·         Fatty fish

·         Pomegranate

·         Turmeric

·         Cayenne

·         Oats

·         Whole grains

·         Beans

·         Eggplant

·         Nuts

·         Apples/berries/citrus fruits

Even if you don’t have PAD, adding these foods to your diet and increasing your weekly movement can help prevent problems. But, if your legs hurt; or if you notice changes like discolored legs or loss of hair on your legs, you may already have PAD. If that’s the case, don’t delay: make an appointment to see a vein specialist in your area right away.

Sources: BelMarraHealth.com

How can an Ultrasound Diagnose Vein Disease?

If your legs are tired, heavy or cramping, your vein specialist may recommend a diagnostic ultrasound. If that is the case, you may be wondering: how will an ultrasound uncover what’s going on inside my legs? Isn’t that kind of technology more common in Obstetrics offices?

Well, you’re partially correct: interventional radiologists use a different kind of ultrasound to diagnose conditions like Peripheral Arterial Disease (PAD.) The technology we use is known as a Doppler ultrasound. And in this post, we’ll teach you how it helps us detect many different kinds of vein disease.

What conditions can a Doppler ultrasound detect?

Doppler ultrasounds check your blood flow. They help us discover whether you have problems like narrowing, leaking or blockages in your blood vessels.

This type of ultrasound uses sound waves to check how well blood flows through your legs. Those waves bounce off your moving blood cells, giving your doctors a better picture of the speed and health of your blood flow. Doppler ultrasounds involve hand-held devices; screenings are pain free and non-invasive.

Using a Doppler ultrasound, vein specialists can detect disruptions in your blood flow, hardening of your arteries and even potentially life threatening conditions like Deep Vein Thrombosis (DVT), a blood clot that develops in the deep veins of your legs that rest well below the skin’s surface.

When should I get a Doppler ultrasound?

We may recommend an ultrasound if there are signs that your blood flow has been reduced. These symptoms can include changes in the appearance of the skin on your legs, leg pain that appears with movement, hair loss on your legs or even wounds that won’t heal.

If you’ve had a blood clot, or we suspect you have one, a Doppler ultrasound can quickly confirm this diagnosis.

We may also recommend a Doppler ultrasound if you’ve recently had a stroke or heart attack. That way, we can determine whether compromised blood flow or clots may be putting you at risk for a repeat problem.

What’s involved in a diagnostic ultrasound for vein disease?

You’ll typically lie down for your ultrasound. Your ultrasound technician may measure pressure in certain areas of your body by apply blood pressure cuffs at points like your ankles, calves or thighs.

Next, your technician will apply lubricant to the  ultarasound guide (called a transducer). Then he or she will move the device over your skin until we receive a good image of your blood flow.  A Doppler ultrasound typically takes up to 45 minutes. Once it’s done, you are usually free to get up and go back to your daily activities.

When you have an ultrasound in our Houston area vein clinics, your results will be reviewed and delivered to you by one of our highly trained team members. If a problem is detected, we will then take the time to discuss and explain your diagnosis, and walk you through all your possible treatment options.

 

What is Critical Limb Ischemia?

The American Heart Association has new guidelines for diagnosing and treating CLI (critical limb ischemia.) But in order to understand the guidelines, we must first understand the condition itself.

What is Critical Limb Ischemia?

Critical limb ischemia (CLI) is a severe blockage in the arteries of your lower extremities. It heartbeat icondramatically reduces blood flow to your lower limbs, making it a serious form of PAD (peripheral arterial disease). PAD and CLI are both caused by a buildup of plaque in your arteries. And that buildup leads to atherosclerosis, the hardening and narrowing of your arteries.

CLI is a painful, chronic condition. It makes your feet or toes hurt, even when you’re resting. If CLI is advanced, you may develop ulcers (sores that won’t heal) on your legs or feet. Some CLI patients even need to have an amputation.

Symptoms of Critical Limb Ischemia

The best known CLI symptom is ischemic rest pain, when your legs and feet hurt a lot when you stop moving. Ulcers on your feet and legs are also common. Other symptoms include:

  • Pain or numbness in your feet.
  • Shiny, dry and smooth skin on your legs or feet
  • Thickened toenails
  • A loss of or lessened pulse in your legs or feet
  • Gangrene (dry, black skin) on your legs or feet

Diagnosing and Treating CLI

The American Heart Association (AHA) emphasized the importance of diagnosing and treating CLI.

“Timely diagnosis and treatment is likely to preserve limb viability and improve quality of life,” Mark A. Creager, MD, past AHA president and director, explained to theheart.org. Reasons for a Vein Evaluation

Why? CLI affects an estimated 12 million adults in the United States, but diagnosing and managing the condition can be “challenging.” Moreover, strategies for perfusion assessment (testing your cardiovascular system’s ability to supply your tissue with enough blood flow) “remain limited,” according to Dr. Sanjay Misra of the Mayo Clinic. And evaluating limb perfusion is crucial because it speeds up the CLI diagnosis and prevents many invasive procedures.

What has Changed with the New CLI Guidelines?

Currently, the guidelines for diagnosing CLI tell physicians to look for ischemic rest pain, an ulcer, or the presence of gangrene for at least 2 weeks. Those symptoms, in combination with reduced blood flow (hypoperfusion) as measured by one of several tests (ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oximetry (TcPo2), or skin perfusion pressure (SPP)) would indicate that a person has developed CLI.

Until now, vein specialists were been most likely to use the ankle-brachial index (ABI) to detect CLI. But under the new guidelines, the American Heart Association suggests that checking toe pressure will deliver a more accurate diagnosis.

Interestingly, the AHA also promotes experimental technologies for checking blood flow in your lower extremities, including a contrast-enhanced ultrasound like the kind we can provide in our Houston area vein clinics.

Regarding this kind of scan, the statement says: “New technologies offer potential opportunities to improve the precision and quality of CLI management,” helping detect and treat CLI at an earlier stage and reducing the number of amputations associated with this condition.

Sources: American Heart Association, health.ucdavis.edu, medscape.com