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What are some warning signs or symptoms that you should get a PAD screening? [Dr. Shams]

Q: What are some warning signs or symptoms that you should get a PAD screening?

A: Patients with Peripheral Artery Disease may begin with mild symptoms or actually go straight to severe symptoms. A mild symptom associated with Peripheral Artery Disease is something called claudication, which means pain in the back of the calf when walking. In general, when you’re not walking, you’re not stressing the blood vessels. You don’t need as much blood flow. If you’re sitting, you need a very small amount of blood flow to the legs to maintain consistency. But when you’re walking, you’re exercising and you need a lot more blood flow to the legs. If you have a blockage in the blood vessel, you can’t get that extra blood flow that you need into the legs, and therefore your body will develop pain because it needs the oxygen to feel normal. Therefore the first sign may be claudication. You may start walking a block or two blocks and start developing pain in the back of the calf, which makes you have to stop and rest. That’s one of the earliest signs of claudication.

A more significant and later sign of Peripheral Artery Disease is something called rest pain. Normally, you shouldn’t have any pain within your feet or your toes at rest. Sometimes, when you’re not getting enough blood flow, you may get severe pain, coolness, or numbness in the toes. Even when you’re lying down, it’s hurting and may require you to shake the toe, rub the toe, or even have to sit up to have gravity help you get some blood flow into that foot. That’s a later sign for Peripheral Artery Disease. More severe stages are seen in patients who have developed a small wound. We know diabetics are at risk of developing severe infections even just with minor injuries. They may cut the toes wrong and get a small wound that, within a couple of days, can develop into a very severe infection. Poor wound healing, particularly in the extremities, is another sign. Lastly, gangrene, which is when a toe or a foot turns black, is the latest sign. This is indicative that the limb or organ is dead and it has to be removed.

More videos from the interview with Dr. Shams of the Lower Manhattan Endovascular Center as he explains the warning signs of Peripheral Artery Disease: 

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