HEALTH SCOUT
It’s a leg attack
DR. ASHOK GUPTA
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Do you have constant pain in the legs? Then check with your doctor. It may be the beginning of peripheral vascular disease.
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If you have pain in your legs while walking or a continuous burning sensation in the toes, you could be suffering from peripheral vascular disease (PVD), the first symptom of which is a “leg attack”, more dangerous than a heart attack.
Though there has been an exponential rise in vascular problems in India mainly because of increasing incidence of diabetes and smoking, the disease is being diagnosed late due to lack of awareness among the public as well as the medical fraternity. Smokers, diabetics and those aged above 50 are at the risk of developing vascular diseases.
PVD mainly affects the legs. The problem initially causes pain in the calf muscles while walking and the walking distance progressively reduces. If ignored, it results in severe pain in the toes even while resting and can eventually lead to gangrene of the toes and foot, which might necessitate amputation.
Indications
Leg attack can endanger the patient’s limb and life. Blocked arteries in the leg mirror the rest of the body. When a patient has blocked arteries in the heart (which causes heart attack) it indicates that there is 30 per cent chance of the patient having vascular disease in other parts of the body.
But a blocked artery in the leg indicates that there could be a 60 to 70 per cent chance of vascular disease in other parts of the body. It is well established now that decreased blood flow in the legs is the biggest indicator of future heart attacks, strokes (brain attack) and amputation of legs. Hence it is recommended that these risks groups should be examined for peripheral arterial disease in the legs.
Initial stage
But leg attacks can be easily treated in the initial stages with appropriate medicines and simple lifestyle modifications if the patient approaches a qualified vascular surgeon. Even if a patient comes a little late, most of the limbs can be salvaged by vascular bypass or angioplasty and stenting. In fact vascular bypass procedures in the leg precede “heart bypass” by many years!
Need for awareness
Though there is a variety of treatment available, there is appalling ignorance about it. In fact a majority of patients are not seen by a vascular surgeon resulting in unnecessary loss of limb and life.
Even when a patient is late, most of the limbs can be salvaged with a high degree of success and low complication rate by vascular bypass or minimally invasive end vascular procedures like angioplasty and stenting if needed. As there are only about 50 vascular surgeons in India, other specialists often see the patient resulting in delayed referral.
PVD remains a common condition associated with a functional disability and risk of limb/life loss. The issue, therefore, is to detect the disease to prevent further cardiovascular morbidity and mortality. PVD affects the legs eight times more commonly than the arms and is also known as Lower Limb Ischaemia.
Therefore there is great need of awareness among public and medical professionals about vascular disease and the role played by vascular surgeon.
The writer is a Vascular and Endovascular Surgeon based in New Delhi. E-mail: gupta_ashok2000@yahoo.com
Symptoms
Leg and foot become cold
Blue or red discolouration of legs
Tingling sensation, numbness or pain in legs
Wounds or ulcers that do not heal
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