PVD (peripheral vascular disease) is a gradual, progressive circulatory
illness. PVD can be caused by a blood vessel narrowing, obstruction,
or spasm. PVD can affect any blood artery other than the heart, such
as the arteries, veins, and lymphatic vessels. Organs fed by these
vessels, such as the brain and legs, may not receive enough blood
flow to operate properly. The legs and feet, on the other hand, are
the most usually afflicted (Peripheral Vascular Disease, 2019). As
WHO determined health to be a state of complete physical, mental
and social well-being and not merely the absence of disease and
infirmity, the progressive process of PVD leads to chronic physical
complications that can affect not just quality of life, but the longevity
of it as well.
Utilizing the Fontaine Classification system established in 1952, it
grades clinical presentation of symptoms into four stages. In Stage I,
the patient is asymptomatic with an incomplete blood vessel
obstruction. Stage II is separated in three substages. Stage II features
mild claudication pain in a limb. Stage IIA, the claudication is at
greater than 200 meters. Stage IIB, claudication is at a distance less
than 200 meters. Claudication is where cramping pain is present in
the leg by induced exercise (Claudication - Symptoms and causes,
2018). Stage III, pain is present when at rest, typically in the feet.
Stage IV, necrosis presents in the affected limb(s) (Hardman et al.,
2014).
Clinical manifestations include symptoms of pain during activity
(Story, 2018). Other symptoms experienced by the patient include
pain, intermittent claudication, numbness, burning, and impotency
(Story, 2018). Other observational signs include hair loss in distal
extremities and nonhealing wounds that could indicate PVD
prompting further diagnostic testing.
Diagnostics, beyond patient history and physical examinations,
include ankle/brachial index reading to compare blood pressure in
the arms versus the legs, treadmill exercises, angiography,
ultrasounds, and MRIs to get a better understanding of the vascular
status in the affected areas for arthrosclerosis, as it is one of the
leading causes of PVD.
Claudication - Symptoms and causes. (2018). Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/claudication/sympt
oms-causes/syc-20370952
Hardman, R., Jazaeri, O., Yi, J., Smith, M., & Gupta, R. (2014).
Overview of Classification Systems in Peripheral Artery
Disease. Seminars in Interventional Radiology, 31(04), 378–388.
https://doi.org/10.1055/s-0034-1393976
Peripheral Vascular Disease. (2019). John Hopkins Medicine.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/p
eripheral-vascular-disease
Story, L. (2018). Pathophysiology : a practical approach (3rd ed.). Jones
& Bartlett Learning.
