Circulatory disorders of the lower extremities
Symptoms of circulatory disorders of the lower extremities
Poor circulation in the lower extremities means reduced blood flow to the extremities due to narrowing or blockage of the arteries. It is accompanied by pain while walking, which disappears during a stop. This is called intermittent claudication. It can be triggered by various diseases, but it always indicates serious problems with the arteries. Therefore, at the first appearance of symptoms, you should consult a doctor and diagnose.
The following risk factors for intermittent claudication are known:
- smoking;
- alcohol consumption;
- obesity;
- mature age;
- stress;
- diabetes;
- genetics;
- violation of lipid metabolism.
With intermittent claudication, pain can occur in various parts of the leg: starting from the foot and rising higher to the lower leg, knee, hip, in some it reaches the lower back. Sometimes the symptoms of circulatory disorders are heaviness or weakness in the legs, cramps, numbness, chilliness. In isolated cases, peripheral arterial disease does not give any symptoms at all.
Causes of circulatory disorders of the lower extremities
There are many causes of circulatory disorders, but they can be divided into three large groups: damage to the arteries (peripheral parts), vasoconstriction due to the formation of atherosclerotic plaques, inflammation of the artery wall, arterial spasm.
The most common causes of such disorders are the following diseases:
· Obliterating atherosclerosis of the lower extremities. It affects people of both sexes, of different ages, but more often men after forty. Cholesterol and fat-like substances (lipids) accumulate in the vessel and form sclerotic plaques, which leads to complete or partial blockage of the vessel.
· Obliterating endarteritis (thromboangiitis). Chronic autoimmune vascular disease. Blood does not flow in sufficient quantities due to spasmodic vessels of the thigh. Young people (men) are especially susceptible to this rapidly progressing disease, since bad habits greatly contribute to the development of this disease.
· Damage of blood vessels by diabetes mellitus. The most terrible complication is the so-called diabetic foot. Due to insufficient blood circulation in the lower extremities, purulent-necrotic rotting of the leg, gangrene begins, which often leads to amputation.
· Varicose veins (or thrombophlebitis). The outflow of blood is disturbed, the walls of the vessels weaken.
Diagnosis of circulatory disorders of the lower extremities
When making a diagnosis and choosing the most suitable method of treatment for a doctor, factors such as the cause of the disease (atherosclerosis, endarteritis, etc.), localization (depth of the lesion), the type of lesion (complete or partial closure of the vessel), and the degree of arterial damage are important. For the convenience of diagnosis, arterial insufficiency was divided into stages, depending on the symptoms:
- Stage I (full compensation): fatigue, chilliness of the feet, numbness and tingling that appears only after physical exertion;
- Stage II (failure during functional loads): intermittent claudication is added to the symptoms of the first stage, forcing the patient to slow down or stop;
- Stage III (failure at rest): accompanied by continuous pain or pain at night;
- Stage IV (ulcerative-necrotic changes in the limb): accompanied by ischemic pain, signs of gangrene appear. Patients require narcotic pain relievers.
To diagnose circulatory disorders, various methods are used and the patient just needs to contact a specialist (surgeon) who will conduct an on-site examination, palpation, percussion (tapping), auscultation (listening to the work of organs). After that, you will need to pass mandatory studies, such as:
· Ultrasound dopplerography of blood vessels (demonstration in real time of the direction, velocity and volume of blood flow);
· Angiography (contrast X-ray examination of the state of blood vessels and blood flow);
· Capillaroscopy (non-invasive method for studying microcirculation at the tissue level);
· Thermometry (measurement of skin temperature);
· Magnetic resonance angiography or MRI with contrast (a contrast agent is injected intravenously, which provides more detailed information than with MRI).
Treatment of circulatory disorders of the lower extremities
After clarifying the diagnosis, the doctor will be able to prescribe the appropriate treatment. Treatment of circulatory disorders in the extremities can be divided into two types: physiotherapeutic (conservative) and surgical (operative). In order not to have to resort to surgical treatment, you should promptly consult a doctor and start physiotherapy. For positive dynamics of recovery, it is imperative to give up bad habits, such as smoking, drinking alcohol, eating fatty foods, and an inactive lifestyle.
In addition, the doctor will prescribe pharmacological treatment. The line of drugs can be divided into the following groups: antiplatelet agents (prevention of atherosclerosis of the arteries, increase blood flow, with intermittent claudication, increase the distance traveled), anticoagulants (prevention of blood clots, inhibit blood clotting activity).
If the patient did not seek help on time and did not start treatment, it is likely that there will be a need for surgical treatment, which can be divided into two types: angioplasty and open surgery. Angioplasty - a thin catheter with a balloon at the end is inserted through a puncture in the groin into the artery to the point of blockage. Having reached the desired area, the balloon inflates, thereby dilating the artery and restoring blood flow. A stent is placed in this place to prevent narrowing of the artery.
Circulatory disorders of the lower extremities are successfully treated today, but the success of treatment largely depends on the patient himself and his self-control.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
