Serious vascular disease sometimes hides behind seemingly minor signs that, left untreated, can cause major health problems.
Such is the case with some artery and vein ailments like blood clots, varicose veins, carotid artery disease (CAD), aneurysms and stroke, according to Brad Sweda, M.D., vascular surgeon at Sanford Health in Sioux Falls, South Dakota.
What is vascular disease?
The term “vascular” refers to all of the body’s vessels and arteries, aside from the heart, which is often referred to as cardiovascular.
Dr. Sweda says many health conditions that are risk factors for heart disease are also risk factors for vascular disease. The most common risk factors are a history of smoking, high blood pressure and diabetes.
“We see people anywhere from their twenties to their eighties,” said Dr. Sweda.
Smoking is known to damage arteries. High-fat diets and sedentary lifestyles can increase blood pressure and cause diabetes.
Other factors, like genetics and stress, can also be risk factors for vascular disease. Dr. Sweda says it’s important to know your family history of strokes and aneurysms, and talk to a doctor to see if a screening test or lifestyle modifications would be right for you to prevent vascular disease.
Warning signs and prevention
Though vascular disease can strike without warning, sometimes people have vision changes or slurred speech, which indicate poor blood circulation to the head and brain through the arteries in their neck.
Dr. Sweda works with primary care doctors at Sanford Health to screen their patients in hopes of catching vascular warning signs early.
He asks primary care doctors to refer patients who fall into three or more of these categories:
- Over 55 years of age
- Active smoker or recently quit smoking
- Have heart disease or regularly see a cardiologist
- Have mild renal or kidney dysfunction
- Have high or abnormal cholesterol
In his experience, patients don’t often think to bring up issues, like trouble walking, unless the doctor asks first.
“The good news is, if you ask them about walking and their feet, you will start to pick up problems they may be dealing with,” Dr. Sweda said.
If a doctor determines 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’s very serious.
“This is an excellent tool. It doesn’t hurt, and it’s very reliable,” said Dr. Sweda. “It can quickly determine where any type of symptoms or any problems exist in the neck or the legs.”
In addition to living a healthy lifestyle, regular heart and vascular screenings can help catch issues before they turn more serious.
“Our biggest battle is always awareness,” said Dr. Sweda. “It’s making people aware that these problems are not insignificant, and they have significant bad consequences if ignored.”
Strokes, mini strokes and CAD
When plaque builds up in the arteries, it narrows the arteries over time, which creates a blockage and lack of oxygen. A stroke happens when there’s a lack of oxygen to the brain.
The brain is the control center for the body, so when there’s a lack of blood flow to it, people can’t get words out, they can’t move part of their body. Sometimes a piece of plaque breaks off and goes into the eye. These are all signs that’s there’s a lack of oxygen to the brain.
Some people have a mini stroke and that can be an early warning sign of a bigger stroke in the future, which could include facial drooping that goes away. If they have that, they should be seen immediately.
Dr. Sweda says one of the most common problems he treats is carotid artery disease, which is also known as CAD. CAD occurs when the vessels that connect the heart to the brain narrow. It often leads to a blockage of the blood flow, if not caught in time.
“I’m very passionate about CAD because this stroke is one of the top leading causes of death and really significant morbidity,” he said. “A large segment of those strokes are caused from disease that involves the neck arteries.”
Hardening of the arteries
Arteriosclerosis, or hardening of the arteries, is a big chunk of the vascular disease practice. Once you have it, you don’t ever get rid of it. When someone is diagnosed with this, doctors typically recommend lifestyle modifications.
Sometimes it shows up as cramps in the legs when walking because of a lack of oxygen.
Limb amputation is unfortunately very common in these instances, according to Dr. Sweda. Medication can help with leg pain to ideally get the patient’s circulation built back up to avoid amputation.
Some people consider varicose veins an aesthetic issue only, but they can itch, burn, break open and bleed. They can also cause leg swelling and heaviness.
Vascular specialists will work to try to figure out what’s causing the varicose vein. Compression stockings are often used, or a simple screening where the patient elevates the legs. Doctors may even close down that vein and shut down extra blood that’s pooling in the leg.
If left untreated, it can also lead to amputation.
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