WHAT IS PERIPHERAL VASCULAR DISEASE (PVD)?
Peripheral Vascular Disease (PVD) Definition: PVD stands for Peripheral Vascular Disease. Peripheral vascular disease is commonly seen in patients with diabetes. The cousin of Peripheral Arterial Disease is Peripheral Venous Disease, which is called venous insufficiency. Peripheral vascular disease is when someone has blocked arteries and vein problems in the legs.
As an interventional cardiologist in Passaic, New Jersey, I am passionate about treating vascular disease and improving your vascular health. Sometimes people have so many risk factors they don’t understand.
Unfortunately, I am seeing an increase in the number of amputations as a result of undetected peripheral vascular disease. Peripheral vascular disease is one of the primary areas that is often missed by health care providers. Peripheral vascular disease is more common than you think.
Peripheral arterial disease impacts 20 million Americans. Vascular issues like peripheral artery disease or peripheral vascular disease are actually relatively easy to detect, fix and prevent. However, we can’t find what we aren’t looking for.
That is why I am on a mission to educate doctors, referring physicians and the community at large about the early signs of vascular disease, particularly in high risk diabetic patients.
FACT: PVD is more common than PAD.
PVD doesn’t necessarily lead to amputation, but it can cause varicose veins, ulcers, swelling, and discomfort. It is a major lifestyle issue and we are seeing PAD and PVD in younger patients in their 30s and 40s. Part of this is because we now have the technology to detect PVD, so we are finding it faster.
In this article on PVD, you will learn:
• What causes peripheral vascular disease?
• What is peripheral artery disease?
• Prevention of peripheral vascular disease
Venous disease and peripheral arterial disease
How does atherosclerosis cause disease?
There is significant overlap between Venous Disease (chronic venous insufficiency) and Peripheral Arterial Disease. When we talk about vasculature or circulation, there are arteries that feed the legs and there are veins that bring the blood back. There is a tremendous overlap of cardiovascular and vascular issues. For example, when somebody is diabetic, they can often end up having arterial and venous issues and sometimes the symptoms are very similar.
FACT: Chronic Venous Disease (CVD) impacts between 40 to 60 million Americans, but few seek treatment.
These are common problems with tremendous overlap. People often get vascular disease because they have heart problems. Oftentimes when they get heart problems, they always had that risk of having heart problems because they had underlying vascular problems to begin with. That is why it is critical to pay attention to all vascular symptoms.
Cardiology & Vascular Surgeons: Why every cardiac patient should see a cardiologist and a vascular specialist
People who have cardiac issues are at risk of developing peripheral vascular disease (PVD).
Unfortunately, patients who have vascular disease are often at risk of developing cardiac problems. Once someone develops peripheral vascular disease, if a doctor does not intervene and fix it early enough, their future longevity and livelihood goes down.
For example, let’s say a patient has heart surgery or a heart transplant. The survival rate related to that patient amputation and PAD is extreme. The prognosis is worse than having a heart attack or a stroke. Oftentimes there is a tremendous overlap. People who have coronary artery disease (CAD) and a history of myocardial infarction are often the same people who have peripheral vascular disease and who may have a stroke.
Bristol-Myers Squibb did a registry and and divided people into three categories:
- Those who had an obvious heart attack
- Those who had an obvious stroke
- Those were obvious peripheral vascular disease or peripheral disease
When they followed the three groups, the PAD disease group did worse than the other two groups.
How does peripheral vascular disease affect the body?
Legs are the window to the heart. Vascular disease is integral to whole body health. If you have leg symptoms or feel pain when you walk, don’t ignore it and get it checked. It could save your life. When people undergo the process of limb amputation, or even one tiny pinkie of one toe, or one toe on one foot, it starts a terrible cycle. These are the same people who end up losing their entire foot or entire leg on that side and the same people that end up losing the other leg. This leads to a negative cascade which can be extremely dangerous.
Functional peripheral vascular disease
Limb amputation and psychological barriers
What is mild peripheral vascular disease?
There is a critical concept of limb loss without amputation. Sometimes people have undetected and undiagnosed (or misdiagnosed) vascular disease where they haven’t had amputation, but for all practical purposes, they are living life as if they don’t have a limb. They are in so much pain, there’s so much swelling that’s not healing, and they can’t even go to pick up their mail. They can’t do simple chores without being in extreme pain.
Venous problems don’t always necessarily lead to amputation, but they lead to a lot of other symptoms and issues. People get pain, cramps, huge limb swelling, ulcers (which are very painful infections), varicose veins and restless leg syndrome. They can also get unusual itching.
What is the prevalence of chronic venous insufficiency (CVI) in the US?
According to Medscape, CVI is a significant public health problem in the United States. It has been estimated that 2-5% of all Americans have some changes associated with CVI.
Varicose veins are often a symptom of venous disease.
Varicose veins are the tip of the iceberg. On the surface, you may visibly see varicose veins as a cosmetic issue. But varicose veins are not just a cosmetic issue, they signal a deeper underlying health issue.
Venous insufficiency is a common health issue. It is estimated that 30 percent of the U.S. population has some form of venous disease.
READ: How to get rid of varicose veins
Peripheral vascular disease video
PAD vs. PVD: Peripheral artery disease vs. peripheral vascular disease
What is the difference between peripheral artery disease and peripheral vascular disease?
Is peripheral vascular disease (PVD) the same as peripheral artery disease (PAD)?
When we talk about vasculature, we are referring to blood circulation to the legs. When we talk about blood circulation, we are referring to the arteries and veins. Arteries bring the blood to the leg and veins bring blood back from the legs. Arteries that get peripheral arterial disease are typically blockages in different leg arteries. Sometimes other issues like vasculitis, which is inflammation, as well as an aneurysm can also occur. Veins develop the problem of Venous Reflux Disease, which is when the vein gets enlarged and the valves inside don’t close and cause the blood to leak back in the opposite direction.
Which is worse PAD or PVD?
PAD and PVD are both very common health problems. Peripheral vascular disease impacts over 20 million individuals in the United States as opposed to cardiovascular disease, which is cardiac disease or coronary artery disease, which is not nearly as common.
FACT: PAD is more common than coronary artery disease. Venous disease, or peripheral venous disease, impacts 40 to 60 million Americans.
Peripheral arterial disease (PAD) circulation problems
When Circulation problems signify underlying disease.
Peripheral artery disease (PAD) is a narrowing of arteries. Arteries become narrow because of atherosclerosis, which is the buildup of plaque on artery walls. Plaque consists of fat, cholesterol, calcium, and other substances.
The most commonly affected areas by PAD are the legs and feet. With reduced blood flow, the pulse in your legs or feet may be weak or absent. Your body may have developed circulation around the blockage.
Vascular Disease and Pain
What does vascular pain feel like?
People who have vascular pain often experience numbness, tingling, or weakness in the affected area or limb. This feeling is a direct result of the interruption in the blow flow to critical tissue and arteries.
Vascular pain feels like pain after walking that is often relieved after resting. Claudication in the legs is one of the most common symptoms of PAD. Cramping or tiredness is one of the first symptoms people notice when experiencing vascular pain from PAD and PVD.
What are the 6 p’s of peripheral vascular disease?
- 6 Ps:
- Pain (first, sometimes only symptom)
- Paresthesias (late finding)
- Paralysis (late finding)
What causes vascular pain?
Vascular disease and circulatory problems can cause pain including when there is a blockage of the arteries or when your veins are not working properly. Vascular ruptures or breakages in the arteries can also cause pain.
Many kinds of vascular diseases have the potential to cause pain including the following:
- Chronic Venous Insufficiency
- Deep Vein Thrombosis (DVT)
- Critical Limb Ischemia
- Peripheral vascular disease(PVD)
- Varicose Veins
READ: Harvard: Could leg pain be peripheral artery disease?
Why do my veins hurt in my legs?
Vein pain in your legs should be taken very seriously.
Peripheral Artery Disease and Leg Pain at Night
Why do my veins hurt in my legs at night?
If your veins hurt more at night, you will want to be checked for PAD, PVD and painful varicose veins. Leg pain at night is often one of the most common signs of vascular disease. Nighttime leg pain could be a sign of critical limb ischemia (CLI).
Peripheral vascular disease (PAD) RISK FACTORS
Who is at risk for peripheral vascular disease?
Peripheral vascular disease is commonly seen in patients with diabetes.
Studies show that 4 in 10 people with PAD do not have leg pain.
Source: American Heart Association
What is the root cause of PAD?
Atherosclerosis is the same fundamental disease process as heart disease, so it can affect arteries anywhere in the body, including in the lower extremities.
Atherosclerosis is the mechanism of calcification and intramural thrombus formation in arteries. It is the most common cause of coronary artery disease and cerebrovascular disease.
PAD is the process of blockages in the leg arteries. Just like with coronary artery disease (CAD), which is a blockage in the heart arteries, similar risk factors play a role in vascular disease including hypertension, diabetes, high cholesterol, genetics, family history, poor dietary habits, and not paying attention to nutrition.
What conditions are linked to PVD?
How does smoking cause peripheral vascular disease?
If somebody has diabetes and is a smoker I don’t need to question if they have PAD. I already know they have it. It’s a matter of where and what degree and what level of peripheral vascular disease.
DIABETES. Having diabetes puts you at high risk for PAD, especially if your disease is not well managed. High blood glucose damages blood vessels. It also affects the nerves, which can mask claudication symptoms.
SMOKING. Smoking is a significant risk factor for PAD. Quitting smoking can reduce progression of PAD, but it can’t reverse damage that’s already occurred. Smoking has gone down, but vaping has gone up. Pick your poison.
RISK FACTOR CONTROL. Other risk factors for peripheral vascular disease (PVD) include high cholesterol, high blood pressure and genetic predisposition. You have a complete substrate based on your risk factors like diabetes, smoking, and high blood pressure, and then you’re waiting for a foot attack, which can potentially lead to dangerous consequences like losing a limb. If you are a smoker or have diabetes, get checked for peripheral artery disease. Make sure you are on all the appropriate medications and exercise. Early detection and peripheral arterial disease screening are critical.
Complications of peripheral vascular disease
Peripheral Arterial Disease in Younger Patients
PAD only impacts the elderly: false.
Are you seeing PAD in young people at all, or is it primarily with the elderly?
We recently heard from the CDC and the WHO that the age group is actually much younger for those impacted by COVID-19. Is the same true for peripheral arterial disease? Unfortunately, no.
We are seeing more young people with peripheral vascular disease. What I see more commonly in younger people is peripheral venous disease, which is a type of vascular problem.
PVD is a cousin of peripheral arterial disease (PAD).
Twenty years ago, if you were in your 40s and 50s, you would not get tested because the misconception about PAD was that it only occurred in older adults. In reality, lifestyles have changed. Today, the stress levels in younger people have become tremendously high with increasing workplace demands and economic pressure. As a result, vascular surgeons are now observing the risk factors for PAD in patients who are significantly younger, and much earlier in life, too.
People who would have otherwise died are not dying from cardiac disease and they’re not dying from cancer.
PAD is also a disease of old age and it is more likely in the elderly demographic.
Because people are now living longer, we are seeing an increase in PAD. We used to see people in their 60s with PAD and now we are seeing people in their 50s and 40s getting peripheral vascular disease as well.
People are also living longer and they are surviving their heart attack and stroke.
Twenty years ago, if somebody had diabetes and they were on dialysis or if they had other underlying risk factors, their likelihood of surviving was significantly lower.
To the credit of the medical community and advancements in the field of cardiology, a lot of incredible treatment options now exist when someone has coronary artery disease or when they have a serious heart problem. We are making people live a lot longer.
Let’s say the average lifespan was around 65 years old for somebody with multiple risk factors. Now they’re living 10, 15, 20 years longer. Later on in their lives, we are now seeing PAD and all these other problems. So that’s why we are seeing a tsunami of PAD problems. Historically speaking, every ten years, the incidence of peripheral vascular disease grows.
FACT: PAD used to be 4 to 5 million people in 2000 and now it’s around 20 million people who have some form of PAD. PAD has grown five times in the last ten years.
Peripheral vascular disease symptoms
What are the symptoms of peripheral vascular disease (PVD)?
Peripheral vascular disease (PAD) symptoms include:
Signs and symptoms of peripheral vascular disease
- Leg pain
- Restless leg syndrome
- Open sores or ulcers that are healing
- Open wound on the lower extremity that is not healing
- Reduced toenail growth or fungal infections that don’t clear up easily
- Hair loss on your toes or legs
- Pain in the legs and feet
- Pain on the top of your toes
- Angina in the legs
- Non-healing wounds
Claudication in peripheral vascular disease
Why is it important to identify patients with claudication?
A classic PAD symptom is called claudication, which is a cramping sensation you feel in the calves when walking. It is important to identify patients with claudication because it is considered a warning of significant atherosclerosis in the circulatory system.
[Did you know] The origin of the term “claudication” can be traced back to Claudius, the Roman emperor, who had a marked limp. Source: Charles Dinerstein, M.D.
NORMAL AGING OR PAD?
Unlike other diseases, early detection of PAD can be difficult because symptoms may be difficult to detect and are often misattributed to other factors such as old age. Seniors often mistake PAD for other issues.
PERIPHERAL VASCULAR DISEASE SYMPTOMS
Hair loss. Skin changes. Fungal infections – normal aging- or PAD?
Foot pain. Normal aging. Arthritis. Or PAD?
Discomfort at night. Aging. Restless leg syndrome. Or Claudication?
Overexertion. Stops when resting or slowing down. Aging. Or PAD?
Amputation and Peripheral Arterial Disease:
Limb Loss Survival Rate, Cost, and Prevention
The majority of the 200,000 people who suffer amputations annually have:
- High blood pressure
- High cholesterol
- Kidney disease
Along with a major loss of function, amputation is associated with an increased chance of death. Studies show that the rate of death after a lower extremity amputation are about 40% one year after surgery, and about 80% five years after surgery.
The average cost of amputation in the United States is $100,000 per patient per year.
Seek early treatment for PAD to reduce the likelihood of amputation of your foot or leg.
Peripheral vascular disease and diabetes
Can diabetes cause peripheral vascular disease?
According to The Journal of Vascular Surgery, the cost of care for diabetic foot ulcers is estimated to be more than $1.5 billion annually.
Unfortunately, many diabetics do not even realize that they have circulation that is so poor that they could lose a limb.
More than 80% of the amputations happen because of the disease progression, which is completely preventable if it is properly detected and picked up by patients and health care providers.
Amputation Risk Factors and Screening
Can circulation problems lead to limb loss?
Most amputations happen because of Peripheral Arterial Disease, which is lack of blood flow from the legs.
How long do people with diabetes live after amputation?
In 2020, 50% of the patients who have had amputations will not live more than four or five years due to other medical complications.
The likelihood of getting an amputation on the other limb is astronomically high, almost ten times that of any other individual.
At a macro level, there are millions of individuals in the United States living with amputation. Amputation has a tremendous impact on a patient’s livelihood, longevity and quality of life. People who have amputations have a survival rate that is as bad as stage four cancer.
FACT: By bringing attention to PAD and diabetes A1C management, you can prevent 80% of amputations.
AMPUTATION MORTALITY RATES
What are the long-term complications of Peripheral Vascular Disease (PVD)?
What is it about the amputation timeline that makes the potential for death so high?
Amputations are complex surgeries. There is a five to ten percent mortality during the hospital stay.
When we discuss major amputation, we are referring to amputation at the level of the knee or the hip. Below-the-knee amputation or Above-the-amputation, what we medically refer to as BKA and AKA.
When a patient goes for a below-the-knee amputation, there is a one in ten chance they may not even come out of the hospital. When it’s above-the-knee, it’s a one in ten chance they may not actually make it out of the hospital because the surgeries require a lot of anesthesia and potential trauma and stress to the heart during the surgery. Often, these are the very same people who have heart problems to begin with.
That’s why the surgery itself is a risk. Once somebody has surgery and survives the amputation, their functional capacity goes down. A byproduct of this unfortunately reality is that people cannot function in the community the same way they otherwise would have and they should be doing aggressive occupational therapy and rehabilitation.
More often than not, people lose their ability to walk a lot even with a prosthesis. Once you have a prosthesis, you’re also putting way too much pressure on your other limb.
These patients will end up getting pressure ulcers on the contralateral limb, which is the limb that did not get amputated. That leads to a similar vascular problem in that leg. Once you get amputation in one leg, your risk of getting amputation in the other leg significantly goes up.
Once people develop this problem, they end up requiring having to stay in the nursing homes and in an assisted living facility and they end up getting a decubitus ulcer, because they are putting too much pressure on that limb and they get frequent infections.
They go to the hospital, catch more hospital-acquired infections, and enter this vicious cycle where amputation leads to more amputation, which leads to more ulcer formation, which leads to infection, which leads to hospital-acquired infection. They end up getting heart failure. They end up getting GI bleeding. There is a downward spiral that gets started with the index event, which oftentimes is the first amputation.
Once you have a certain kind of amputation, up to 40 to 50 percent of people will not live beyond two years. When you follow them up to five years, 60 to 70 percent of them are not alive after five years.
Peripheral vascular disease with amputation case study
FACT: Amputation is as bad as having stage four cancer.
Amputation is preventable, just like some cancers are preventable. But unfortunately, there is a significant lack of awareness of PAD among health care providers. Primary care physicians and podiatrists are not aware of what options exist for high risk diabetic patients in terms of vascular specialties.
Most people are surprised when they find out that if somebody has a major limb amputation, their risk is higher than stage four breast cancer. The risk is higher than most of the metastatic cancers. The average lifespan after a major amputation is less than fifty percent.
Veterans and amputation. Amputation can happen in a more dramatic situation like war or a helicopter crash, but that is less than 20% of the amputations in the country.
FACT: More veterans end up losing their limbs not because of war-related injuries but because of Peripheral Vascular Disease (PVD). Among veterans, amputation happens more commonly because of underlying risk factors.
How amputations can be avoided: A lot of this is so preventable. If you have any of the above PAD symptoms, do not ignore them and seek immediate medical attention. Talk to your doctor, find a vascular specialist and get basic vascular testing, especially if you have PAD or diabetes risk factors.
PERIPHERAL VASCULAR DISEASE (PAD) TREATMENT
What is the treatment for peripheral vascular disease (PVD)?
Treating PAD and PVD requires a multidisciplinary approach and team of specialists.
How to treat peripheral vascular disease
How is peripheral vascular disease and vascular pain treated?
Effective PAD treatment entails:
- Reducing symptoms of claudication
- Preventing amputation complications
- Improving mobility
- Minimally invasive procedures such as angioplasty, stenting, and atherectomy to improve blood flow.
- Cholesterol lowering medications
- Medications to keep blood from clotting
How do you fix vascular disease?
Bypass surgery is not the gold standard for PAD treatment.
Endovascular and angioplasty is considered the new gold standard for treatment.
Board-certified vascular surgeons and interventional cardiologists have differing views on what the gold standard is for PAD treatment. Ten years ago, bypass graft surgery was considered the gold standard for treating advanced PAD. That is simply no longer the case today. This surgery restores circulation with healthy arteries to go around blockages. However, the healthy arteries used for the bypass can become diseased or even blocked. The best analogy for this is similar to coronary artery bypass surgery.
Endovascular intervention (minimally invasive) is a better way of doing things when treating advanced PAD. It has much less risk for patients. The risk of a heart attack during a bypass surgery is very high. Today, more and more people are going away from bypass. In fact, I can’t remember the last time I sent anyone for bypass. The other big problem with bypass is often, people don’t have vessels where they can suture with a target vessel or a conduit (a healthy vein).
Review endovascular treatment options. Some people think that if they have Peripheral Arterial Disease, they need vascular surgery or bypass surgery. Those days are gone. Today, interventional cardiologists and vascular specialists can fix most of these blockages with a simple catheter-based treatment that takes less than an hour. A New Jersey vascular specialist can use non-invasive tests using ultrasound or pressure gauges to pinpoint the site of arterial narrowing or blockage.
PAD/ PVD Testing & Screening
“Most people get blood pressure tested in their arms, but we can also check blood pressure in your legs.”
How is peripheral vascular disease diagnosed?
PAD is easy to detect by simple testing, a simple physical exam and checking one’s pulse.
Prevention, early detection and seeking treatment early is critical.
- Get screened for PAD/ PVD
- Get your pulse checked in your feet and legs
- Get a blood pressure test of your legs
- Get Ankle Brachial Index Testing
The good news is that with recent advances in technology, PAD is now easy to detect with a number of peripheral vascular disease screening tests. PAD is also easy to prevent. If you cannot prevent it, it is easy to detect. If you do detect it, it is easy to fix, relatively speaking. The key is to find PAD before it is too late.
PAD Testing. Everyone knows about the blood pressure test of the arm, but there is a very simple way to check leg circulation, too. This is done by taking the blood pressure of the leg at the thigh, knee, and ankle level. This Peripheral vascular disease test is called the Ankle-Brachial index (ABI). ABI is simple and very effective.
We can immediately detect PAD by doing a simple blood pressure test of the lower extremity. We compare the blood pressure in the arm with blood pressure in the legs. The blood pressure should never be significantly lower than the blood pressure in the arms. A vascular specialist will check blood pressure at three or four different levels in the lower extremity in both legs, and we compare that with the arm blood pressure, which is only the top number that we usually focus on.
Most insurance covers ABI testing for PAD and even if insurance doesn’t pay for it, most doctors will do ABI testing for peripheral arterial disease. Apex Heart and Vascular provides free PAD screening for anyone who needs this test. It will pick up more than 90% in terms of sensitivity and specificity and only takes 15 minutes. Talk to your vascular specialist and book an appointment today to get tested.
Screening for Peripheral Vascular Disease ICD 10
Examine non-healing wounds. If you have an ulcer or wound that has not healed, ask your podiatrist or vascular specialist to examine the wound. Seek medical attention if you have pain, discomfort, discoloration, if your legs have blue/black spots or the skin color is changing, or if you have an open wound or an ulcer that is not healing. Often, people get a cut in the skin in between two toes that has not healed for a few weeks. That is what we call a non-healing diabetic foot ulcer (DFU). A non-healing ulcer is the most significant precursor of amputation. People with diabetes can often develop critical limb ischemia (CLI), which is a lack of blood flow to the leg.
PAD is also lifestyle-related. People who tend to have PAD have jobs that require them to stand on their feet for extended periods of time. They often get Venous disease. Women tend to get a lot more Venous disease than men. Another major PAD Misconception is that men don’t get vein problems. You know how they say, Men are from Mars, Women are from Venus? That is a joke in medical education that, oh, if it’s a vein problem, men can’t have it. This is completely untrue. Men can very easily have varicose veins, too. They can have Venous problems and we’re seeing a lot of that.
When we talk about hypertension, we focus on arterial hypertension, but there is something called venous hypertension that most people don’t think about and that can lead to PAD. Women get PAD more, especially in women that have had multiple pregnancies. In certain communities where it’s more common to have multiple pregnancies, we see a lot of vein problems.
Varicose and spider vein treatment
[READ MORE:] PERIPHERAL ARTERIAL DISEASE MISCONCEPTIONS
PERIPHERAL ARTERIAL DISEASE PREVENTION
I always tell my patients that the legs are the windows to the heart.
If you have poor circulation, chances are you have poor cardiac health and chances are that you have a poor prognosis.
Unfortunately, with peripheral vascular disease, sometimes the disease is not very visible. That’s the time to really detect it at the asymptomatic level because then you can prevent it. Those screenings for PAD and PVD become very important. But patients don’t understand because they are asymptomatic. They say, well, I’m fine, I don’t have any problems, so why check for peripheral artery disease?
Health care has become a well-oiled machine where people are just going in and out of the office. A lot of providers don’t have time to examine feet or have a sophisticated conversation that why even without any symptoms. But despite having no symptoms, doctors should still check lower extremity circulation.
Podiatrists can be very important in detecting PAD and PAD risk factors.
Your feet mirror your general health. Foot ailments can be your first sign of more serious medical problems such as diabetes and circulatory disorders.
PODIATRIST TIP: When you’re seeing patients in the office, make sure you take their shoes and socks off and check their pulses during the exam. A simple pulse exam in the office will help detect PAD.
You will be shocked to hear how many patients never get their feet checked. Less than one percent of patients have their shoes and socks taken off at annual visits. Less than three percent of people during their routine office visit get their feet and leg pulses checked. Even cardiology offices are less than five percent.
Collectively as healthcare providers, we need to pay more attention to this issue. Raising awareness for PAD is important at the patient level, the community level, and at the health care provider level.
Why is there a lack of early detection for PAD?
Often, the drive to get PAD screening and early detection is not there for the patient or the patient’s family. Unfortunately, many primary caregivers and health care providers frequently misdiagnose PAD.
The medical community has not done a great job at raising awareness for PAD. In October, everyone wears pink from NFL players to breast cancer awareness everywhere. The breast cancer community has done a great job in raising awareness.
PAD Awareness Month: Every September, the team at Apex Heart and Vascular wears white socks to raise awareness for peripheral arterial disease. We support the movement to save limbs and save lives and prevent amputation and prevent any kind of vascular disease.
Stay on your feet—treat PAD early
Effective vascular intervention can help you stay active and independent for a longer time.
Why choose Dr. Anuj Shah for treatment of peripheral vascular disease?
Do you have pain if you walk at an ordinary pace on level ground? Do you have pain if you walk uphill or hurry? Does the pain ever begin when you are standing still or sitting? If so, you may have PVD. If you are in pain from vascular disease, contact us today to set up an appointment for vascular testing in New Jersey.
A peripheral vascular disease diagnosis is significant. If you are concerned about peripheral vascular disease in your legs, we can help you manage it.
BOOK AN APT. Detect PAD today with a 15-minute blood pressure test.
Apex Heart and Vascular is proud to serve the Passaic, New Jersey community and surrounding areas in vascular disease education, prevention, and treatment for over 12 years. Our vascular physicians are dedicated to helping our patients better understand how we can help you with vascular disease. If you would like more information about our vascular health procedures in Passaic New Jersey, please contact us to schedule an appointment or call us at (973)-916-0002.
ABOUT THE AUTHOR
Dr. Anuj R. Shah is an interventional cardiologist and an endovascular specialist originally trained at Mt. Sinai. He has been in practice for 11 years and is passionate about the improvement of leg circulation and peripheral arterial disease. He is currently the Director of Apex Heart and Vascular and has privileges at Mount Sinai as an assistant professor.
Peripheral vascular disease patient education
Society for Vascular Surgery PAD