House Call: Peripheral Arterial Disease of the Lower Extremities
Peripheral Arterial Disease (PAD) is blockage of arteries outside of the heart and brain.
PAD can severely affect an individual’s quality of life, and increase risk of life-threatening health conditions, such as heart attack and stroke. Specifically, PAD of the lower extremities often makes walking difficult, and if left untreated, can lead to the need for limb amputation.
A major sign of PAD is claudication, which involves fatigue, heaviness, tiredness, and cramping in the leg muscles that occurs during activities such as walking or climbing stairs.
Location of the pain can often be an indicator of where the blockage is in the body. Blockages in the aorta or iliac arteries (both located in the trunk of the body) often cause pain in the hips, buttocks and thighs. Blockages in the thigh often cause pain in the calf muscles.
The main risk factors of PAD include smoking, high cholesterol, high blood pressure and diabetes.
Once PAD is detected, often through the use of an ankle brachial index or ultrasound device that checks the blood pressure in your leg and arm, there are several treatment options. The first line of treatment is medical therapy which focuses on risk factor modification to reduce cardiovascular events, improve quality of life and survival. The second line of treatment involves minimally invasive procedures such as balloon angioplasty and stenting, and atherectomy. The third line of treatment involves surgical bypass of the arteries in the leg or arm. Treatment for PAD is always individualized and based on the severity of symptoms.
Cone Health has an exceptional network of cardiologists and related healthcare providers dedicated to treating peripheral arterial disease to improve patients’ quality of life, and prevent heart attack, stroke and amputation.
Dr. Jonathan Berry is a cardiologist at Southeastern Heart and Vascular Center and the cardiovascular section chief and medical director of the peripheral vascular lab at Cone Health. Dr. Berry is a 1983 graduate of University of Pennsylvania School of Medicine, completing his residency in internal medicine at Duke University Medical Center. He specializes in interventional cardiology and peripheral vascular disease, completing fellowships at both Duke University Medical Center and University of Michigan Hospitals. Dr. Berry also serves as a clinical professor at UNC Chapel Hill School of Medicine.