Serious vascular disease sometimes hides behind seemingly minor signs that can lead to serious health problems if left untreated.
Such is the case with some arterial and venous diseases such as blood clots, varicose veins, carotid artery disease (CAD), aneurysms and strokes, according to Brad Sweda, MD, a vascular surgeon at Sanford Health in Sioux Falls, South Dakota.
What is vascular disease?
The term “vascular” refers to all the blood vessels and arteries in the body, except for the heart, which is often referred to as cardiovascular.
Many of the health conditions that are risk factors for heart disease are also risk factors for vascular disease, Dr. Sweda said. The most common risk factors are a history of smoking, high blood pressure and diabetes.
“We see people from their 20s to their 80s,” Dr. Sweda said.
Smoking is known to damage arteries. High-fat diets and sedentary lifestyles can increase blood pressure and lead to diabetes.
Other factors, such as genetics and stress, can also be risk factors for vascular disease. it’s important to know your family history of strokes and aneurysms and talk to your doctor to see if screening tests or lifestyle changes are right for you to prevent vascular disease, Dr. Sweda says.
Warning signs and prevention
Although vascular disease can strike without warning, sometimes people experience vision changes or slurred speech that indicate poor circulation through the carotid arteries to the head and brain.
Dr. Sweda works with primary care physicians at Sanford Health to screen patients for early detection of vascular warning signs.
He asks PCPs to refer patients who fall into three or more of the following categories.
– 55 years of age or older
– Active smokers or recently quit smoking
– Patients with diabetes
– Have heart disease or see a cardiologist regularly
– Have mild kidney function or renal insufficiency
– Have high or abnormal cholesterol
In his experience, patients usually don’t want to ask questions, such as difficulty walking, unless the doctor asks first.
“The good news is that if you ask them about walking and their feet, you’ll start to find out what they may be dealing with,” Dr. Sweda says.
If a doctor determines that a patient is at risk for vascular disease, they will be referred to a vascular specialist. Vascular specialists can use a tool called a noninvasive vascular lab, which uses ultrasound technology to diagnose vascular disease before it becomes very serious.
“It’s a great tool. It’s harmless and very reliable,” says Dr. Sweda. “It can quickly determine the presence of any type of symptom or any problem in the neck or legs.”
In addition to leading a healthy lifestyle, regular heart and vascular screenings can help identify problems before they become more serious.
“Our biggest battle is always awareness,” says Dr. Sweda. “It makes people aware that these problems are not trivial and that ignoring them can have serious adverse consequences.”
Strokes, mini-strokes and CAD
When plaque builds up in arteries, it narrows them over time, causing blockages and oxygen deprivation. Strokes can occur when the brain is deprived of oxygen.
The brain is the control center of the body, so when it lacks blood flow, people can’t speak and they can’t move parts of their bodies. Sometimes a plaque comes off and goes into the eye. These are all signs of a lack of oxygen to the brain.
Some people have mild strokes, which can be an early warning sign of a larger stroke in the future, which may include loss of facial droop. If they have them, they should be seen immediately.
Dr. Sweda says one of the most common problems he treats is carotid artery disease, also known as CAD. CAD occurs when the blood vessels that connect the heart to the brain narrow. if left undetected, it often leads to a blockage in blood flow.
“I’m passionate about CAD because this stroke is one of the leading causes of mortality and morbidity at a very high rate,” he says. “A large percentage of these strokes are caused by diseases involving the arteries in the neck.”
Atherosclerosis, or hardening of the arteries, is an important part of the practice of vascular disease. Once you have it, you never get rid of it. When someone is diagnosed with this disease, doctors often recommend lifestyle changes.
Sometimes leg cramps can occur when walking due to lack of oxygen.
Unfortunately, amputations are very common in these cases, according to Dr. Sweda. Medications can help relieve leg pain and ideally restore the patient’s circulation to avoid amputation.
Some people think varicose veins are just an aesthetic problem, but they can itch, burn, rupture and bleed. They can also cause swelling and heaviness in the legs.
A vascular specialist will work to identify the cause of varicose veins. Often compression stockings are used, or a simple screening where the patient elevates the leg. The doctor may even close that vein and shut off the extra blood that accumulates in the leg.
If left untreated, it may also lead to amputation.