Your feet hold clues to the health of your arteries. Although you may not know it, your feet hold clues to the health of your circulation and your heart. By doing one simple thing, your doctor can determine if you have peripheral artery disease, or PAD. Especially if you have diabetes, you are at risk for PAD. Knowing if you have PAD is also helpful in case you have a lower extremity wound, if it is addressed, then your chances of healing increase.
PAD occurs due to a buildup of cholesterol and plaque in the arteries of the lower extremity. When this happens in the heart, it is called coronary artery disease. Many times the presence of heart disease, diabetes, smoking, or family history may predispose you to PAD. The simple test your primary care doctor or podiatrist may do is this: you doctor will examine your feet to see if she can feel pulses in 2 places on your feet and ankles. Just as you can feel circulation at your wrist and on the side of your neck, you should be able to also feel pulses on the top of your foot and also just behind the inner part of your ankle. If you cannot feel your pulse there, then this could signify any form of PAD. The next step would be to have and ankle brachial index test, where blood pressure cuffs and a Doppler will test your bloodflow. It is used in conjunction with information from your blood flow in your arms to determine any deficiencies. The test will give a ratio between the blood flowin your arms and the blood flow in your legs. Any drop in the ratio can indicate PAD.
Sometimes, patients may have an indication that something is going on with the circulation in their legs because they may complain of symptoms of painful legs at rest relieved by dangling them over the side of the bed, or pain after walking a certain distance. PAD testing is essential as there could be a further problem of actual blockage of an artery. If the tests indicate that there may be a blockage, then the next step is a referral to an interventional cardiologist or an interventional radiologist. He may then advise a test called an angiogram. This is more invasive as it involves shooting dye into the arteries of the legs and looking at the blood flow under a special Xray camera. At that time, if there is a blockage that can be seen, the doctor may put in a stent to open the artery. If that is not possible, then you may be referred to a vascular surgeon to talk about options for bypass surgery in the leg.
If you have questions regarding the pulses in your feet, make an appointment with one of our doctors at Prairie Path Foot and Ankle Clinic. We will perform a thorough exam and send you for more testing if needed. So don’t ignore those feet – they are a plethora of information!