Why you should talk to your doctor about PAD

PAD, or peripheral artery disease, affects about 8 million Americans. It can start as early as the age of 20, and becomes more common as one gets older. By age 65, about 12 to 20 percent of the population has some degree of vascular disease. Early diagnosis is critical, as people with PAD have a four to five times higher risk of having a heart attack or stroke. Unfortunately, PAD often goes undiagnosed as symptoms are often mistaken for something else.

So how do you know if you’re at risk for PAD? “Unfortunately, with PAD, sometimes there are factors that the patient can control and sometimes not. Sometimes it runs in the family and your risk factors are genetic,” said Dr. Jeffrey Elbich. “Other risk factors include advanced age, male gender, smoking, especially those with a long smoking history, and people with other medical problems such as diabetes and hypertension.”

Dr. Elbich explained some symptoms to watch out for. “A typical patient will describe walking for a few block and being affected by sudden painful cramps in the legs and thighs that resolve after a period of rest.” He continued, “For every one person who has symptoms, there are three to four who have no symptoms at all. If you have some of the risk factors we just mentioned, it’s important to talk to your doctor and be screened.”

The screening involves a review of the patient’s medical history and any symptoms, followed by a physical exam. “You physician will preform an ABI, or ankle brachial index which measures the blood pressure in your arms, compared to the blood pressure in your ankles,” said Dr. Elbich. “If it’s significantly different, that indicates a blockage in your legs and is indicative of PAD.”

Many peripheral vascular conditions can be diagnosed and treated on an outpatient basis by the interventional radiologists and vascular surgeons here at VCU Baird Vascular Institute. If you want to learn more about peripheral artery disease and treatment options, wish to discuss symptoms or problems you may be experiencing or if your doctor has recommended that you see us for a vascular test, please contact us at (804) 828-2600.

What’s involved in a Vascular Health Screening?

Vascular disease is a broad term that describes a number of conditions of the circulatory system that affect millions of Americans each year.

According to the Society for Vascular Surgery, “Sometimes people who have potentially threatening vascular disease may not be aware of its presence because warning symptoms have not yet developed. For this reason, vascular screening is used as a method to detect the presence of serious vascular disease in the general population before it has a chance to cause harm.”

Vascular diseases range from diseases of the arteries, veins and lymph vessels, to blood disorders that affect circulation. When disease occurs in the arteries, less blood is delivered to the tissues, reducing the oxygen and nutrients needed by the tissues of the body. Types of vascular disease include coronary artery disease, peripheral artery disease (PAD) and peripheral vascular disease (PVD).

Diagnosis of vascular disease is made on the basis of your medical history and symptoms, but generally begins with a physical exam. Your healthcare provider will begin by checking for weak pulses in the legs. Your physical examination may also include the following:

  • Ankle-brachial index (ABI): the ABI is a painless exam that compares the blood pressure in your feet to the blood pressure in your arms to determine how well your blood is flowing. This inexpensive test takes only a few minutes and can be performed by your healthcare professional as part of a routine exam. Normally, the ankle pressure is at least 90 percent of the arm pressure, but with severe narrowing it may be less than 50 percent. If there is an abnormal difference between the blood pressure of the ankle and arm, you may require more testing. Your doctor may recommend one of the following tests:
  • Doppler and Ultrasound (Duplex) imaging: is a non-invasive method that visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of a blockage.
  • Angiography: This procedure is generally reserved for use in conjunction with vascular treatment procedures. During an angiogram, a contrast agent is injected into the artery and X-rays are taken to show blood flow, arteries in the legs and to pinpoint any blockages that may be present.

How should a patient prepare for a vascular screening?

  1. Write down any symptoms you’re experiencing, including any that may seem unrelated to your condition.
  2. Write down key personal information, including a family history.
  3. Make a list of all medications, including OTCs (over-the counter), vitamins and supplements that you’re taking.
  4. Write down questions you want to ask the doctor. List your questions from most important to least important in case time runs out. Some basic questions to ask include:
  • What is likely causing my symptoms?
  • What are other possible causes for my condition?
  • What kinds of tests will I need?
  • What are the risks and benefits of the tests and the treatment plan you recommend?
  • What are the alternatives to the primary approach that you’re suggesting?
  • Are there any diet or activity restrictions that I need to follow, either for the tests or the treatment?
  • Should I see a specialist, and if so can VCU Baird Vascular Institute recommend a specialist?
  • What is the cost of the tests and the treatments?
  • Does insurance usually cover the tests and treatments? (You will need to ask your insurance provider directly for specific information about coverage.)
  • Are there any brochures or other printed material that I can take home with me?
  • What websites do you recommend visiting for more information about my condition?

Meet the care team

Malcolm K. Sydnor Jr., M.D.

As the Director of Vascular and Interventional Radiology at VCU Medical Center, Dr. Sydnor is an integral part of the VCU Baird Vascular Institute care team. He specializes in the diagnosis and treatment of varicose veins and peripheral arterial disease as well as placement of port-a-caths for long term central venous access.

Dr. Malcolm SydnorDr. Sydnor uses imaging guidance to perform minimally invasive treatments. Therefore treatments that used to require major open surgery can now be performed through small incisions without the need of general anesthesia.

Recently, we asked Dr. Sydnor about his work at VCU Baird. Here’s what he had to say.

What is the best part of working at VCU Baird?
Being able to help patients using advanced technology in the comfort of an outpatient facility.

What is the best part of your day?
Seeing patients after you have helped them with their problem and they are excited and happy to have their problem fixed.

Why is VCU Baird unique?
We have experienced academic experts available to patients in a comfortable community setting. And VCU Baird also offers multiple disciplines working together to make sure patients get the best care possible for their vascular disease It’s also wonderful that we have a plentiful support staff whose major priority is creating a comfortable customer-friendly environment for our patients.

Dr. Sydnor also serves as Associate Professor of Radiology and Surgery at VCU Health System and Medical Director of the Baird Vascular Institute. He earned his M.D. from VCU, completed his residency at VCU Medical Center and finished his fellowship at University of Virginia.

Board Certifications Dr. Sydnor holds are:
• American Board of Radiology – Diagnostic Radiology, 2004
• Certificate of Added Qualification – Vascular and Interventional Radiology, 2007

With our friendly, comfortable outpatient environment and skilled physicians with academic expertise, VCU Baird Vascular Institute offers excellent vascular care without the overwhelming experience of a large hospital. For more information, please call (804) 828-2600(804) 828-2600 or email bairdvascularinstitute@mcvh-vcu.edu.