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June 1, 2010 > When Leg Pain Isn't Just Leg Pain

When Leg Pain Isn't Just Leg Pain

Learn About Peripheral Vascular Disease, a Precursor to Heart Attack and Stroke

When we feel pain in one location of the body, most often we assume that's where the problem lies.

But in the case of peripheral vascular disease (PVD), extremity pain - often in the calf region - only tells half the story.

On Tuesday, June 8, from 1 to 3 p.m., Washington Hospital Medical Staff cardiologist Dr. Ash Jain and Washington Hospital Medical Staff vascular surgeon Dr. John Thomas Mehigan will talk about the symptoms, diagnosis and treatment options for PVD. Then, on Saturday, June 12, from 9 a.m. to 1 p.m., the physicians will conduct a free community screening for PVD.

PVD is a disease of the blood vessels outside the heart, which affects the peripheral circulation and sometimes causes pain or cramping in the arms or legs that typically occurs with exercise and subsides with rest.

But leg or arm extremity pain may tell a more complex tale of potential risk to the heart and brain, according to Dr. Jain and Dr. Mehigan.

"The goal is for audience members to learn the signs of PVD and seek help," Dr. Jain says. "If they don't seek help, PVD will begin to cause problems locally in the legs, which leads to discomfort when exercising. As a result, patients become increasingly sedentary and raise their chances of developing other types of vascular disease due to risk factors such as diabetes, high cholesterol, hypertension and obesity."

This is when the real trouble begins.

"When these factors begin affecting heart and brain, patients then have a increased rate of mortality. It's not the leg pain that kills them, but the underlying heart and brain conditions, including heart attack and stroke, that will prove deadly," says Dr. Mehigan.

Dr. Jain adds that if PVD is not addressed, it quickly becomes a vicious cycle of worsening the risk factors that can lead to cardiovascular death.

"You can say, 'It's just my legs that are hurting and I'm not going to deal with it,' but if left untreated, PVD makes regular exercise intolerable - and it is regular exercise that helps prevent cardiac disease. It is good to address PVD and improve your symptoms so that you can exercise regularly."

Risk factors that may indicate PVD - as well as heart disease and stroke - include:
* Diabetes
* Cigarette smoking
* High blood pressure (hypertension)
* High levels of the "bad" cholesterol, low-density lipoprotein (LDL)
* Previous stroke or heart attack
* Obesity
* Sedentary lifestyle (minimal regular exercise)
* Age (Men over age 50 are affected more frequently)
* Family history of heart disease
* Cardiovascular disease, covering several conditions affecting the heart

Dr. Mehigan emphasizes that learning your family history is crucial to understanding whether you are at risk for PVD, heart attack or stroke.

"Examine your family history for these risk factors," he notes. "If you don't know your history, find out about it. What did your mother die of? What did your father die of?"

For example, he points out that if you're 48-years-old and your father died at 52 of a heart attack and your uncle has heart disease and your brother had a stroke, you may be at risk.

"Genes run true," according to Dr. Mehigan.

Free PVD Screening at Washington Hospital

Washington Hospital's upcoming free PVD screening on Saturday, June 12 will use a painless, non-invasive Doppler study to detect whether or not a person has PVD. After the test, the physicians will explain the results and refer participants to their primary care physician if necessary.

"We do the screening program not to have a lot of people who need surgery, but for people who have a mild problem that may become a larger heart problem in the future," Mehigan explains.

In advanced stages, PVD may require more aggressive treatment options, such drug treatment, including medicines to help improve walking distance (cilostazol and pentoxifylline), antiplatelet agents and cholesterol-lowering agents (statins).

For a minority of patients, lifestyle modifications to reverse PVD are not sufficient, and angioplasty or surgery may be necessary.

But, if PVD is caught during early stages, Dr. Jain says the answer is a simple one.

"Ultimately, the solution for improved cardiovascular health is diet and exercise," he says. "Diet and exercise are the mainstays of management. When you start having arterial blockages in the legs, you stop exercising, which does not help your risk factors for cardiac disease and stroke.

"It's important to remember that PVD is a fixable disease. But first, you have to recognize the symptoms and get diagnosed."

Reduce your risk

To learn more about peripheral vascular disease from Dr. Jain and Dr. Mehigan, join them for a free Health & Wellness seminar on Tuesday, June 8, from 1 to 3 p.m. in the Conrad E. Anderson, M.D. Auditorium, located in the Washington West building at 2500 Mowry Avenue in Fremont. Register for the seminar online at

On Saturday, June 12, from 9 a.m. to 1 p.m. a peripheral vascular screening, consisting of a painless, noninvasive Doppler study of the legs, will be held in the Conrad E. Anderson, M.D. Auditorium. To register for the screening, please call (800) 963-7070.

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