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Articles by: Christine A. Moriarty

Peripheral Arterial Disease.


Have you ever known a person whose hands are cold and clammy most of the time? Often, shaking hands with this individual is an uncomfortable situation for both of you.


Symptoms of this sort are one of the signs of Peripheral Arterial Diseases (PAD) such as Buerger’s disease, Raynaud’s disease, and acrocyanosis.


The first thought that most people have is that cold and clammy hands or feet are a normal response when one is feeling nervous. This must be considered but they can also be an indication of a faulty peripheral circulatory system and may warrant further observation since cold hands and feet may be a frequent and regular occurrence in some individuals.


The American Heart Association has noted that peripheral arterial disease occurs in 2.5% of the people aged 40 to 60. The incidence rates rise to 5% at ages 60 to 64, 13% at ages 65 to 69, 16% at ages 70 to 74, and 22% at age 75 and over. 5% of the individuals diagnosed with PAD are at a higher risk of amputation of those extremities that have an insufficient blood supply.


What exactly is peripheral vascular disease? It is defined as any disease of the blood vessels outside of the heart, including diseases of the lymph vessels. It often manifests itself as a narrowing of the vessels carrying blood to the arm and leg muscles. There are two main types within this category of circulatory diseases.


Functional peripheral vascular diseases do not involve defects in the structure of the blood vessels. They usually have short-term effects and may be reversible. Cold temperatures, emotional stress, smoking, or work on machinery that vibrates trigger these incidents. Raynaud’s disease falls into this type of peripheral vascular disease.


Organic peripheral vascular diseases are present when structural changes, such as tissue damage or inflammation, occur in the blood vessels. Buerger’s disease comes under this type.



The best treatment is to prevent reoccurrence by reducing or eliminating the cause of the spasms. Stop smoking because nicotine constricts the blood vessels. Keep the body warm – particularly the trunk, arms, and legs. Some mild sedatives may be prescribed but in severe cases, a surgical procedure called a synipathectomy is effective. Individuals known to have Raynaud’s disease should avoid taking beta-blockers since this medication may cause the disease to become worse.


Buerger’s disease is the result of the obstruction of the small to medium sized arteries – usually caused by inflammation. This disease affects a higher percentage of young to middle aged men who are smokers. The symptoms of Buerger’s disease are coldness, numbness, tingling, or burning in the feet and legs, along with muscle cramps in the legs and the arches of the feet. The foot or hand feels cold, sweats a lot, and is bluish in color.


The treatment is to prevent the decrease in circulation by stopping smoking, eliminating drugs that can affect the blood vessels, and reducing exposure to the cold. Walking twice a day for 15 to 30 minutes is recommended to aid in improving the blood flow. In severe cases where arterial occlusion still occurs after these steps have been taken, severing the nearby nerves to prevent spasm can be effective.


Acrocyanosis is a persistent bluish color of the hands (and sometimes the feet) caused by an undetermined spasm of the small blood vessels in the skin. Although painless, the symptoms include the bluish color, cold, profuse sweating, and occasionally some swelling. Although medication to dilate the arteries can be prescribed, it is not usually very effective.


Because all of these diseases require an extensive history of the symptoms experienced and the frequency of the occurrences, it is not unusual for a diagnosis to take up 1 to 2 years. People with poor circulatory function need to take extra care with their extremities. They should inspect their feet daily for cracks, sores, corns, or calluses.


Use a lubricant such as lanolin for dry skin – do not use a medicated powder. Trim the toenails straight across or seek the services of a podiatrist. Do not wear tight garters or elastic topped stockings. Do not warm the feet with a heating pad or hot water bottle. Do not walk bare foot or wear open toed shoes.
Do wear shoes that fit well and don’t have any tight spots. Do wear wool socks to keep the feet warm, and do wash and dry the feet daily.



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