Column: Foot pain and heart disease

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Commentary by Dr. David Sullivan

Since February is American Heart Month, it’s a good time to talk about peripheral artery disease, or PAD. Did you know the first warning of heart disease could come from your feet?

Foot signals

Have you ever started walking and noticed that your feet or legs hurt? You might have chalked it up to bad shoes or overdoing it on exercise. But in fact, it could be the first sign of PAD. Cramping can also be a sign.

With PAD, your lower extremities don’t get enough oxygen. So, walking or exercising may be painful. But what’s the reason your legs aren’t getting that oxygen? Atherosclerosis — a buildup of plaque inside your arteries—triggers PAD and raises your risk for serious cardiovascular conditions, such as heart attacks or strokes. When plaque builds on your artery walls, it makes it harder for oxygen-rich blood to travel from your heart to the rest of your body, especially from the legs and feet.

Diagnosing PAD

Not all foot pain is a sign of PAD. But if the pain shows up when you move, and disappears when you rest, it’s worth discussing. You may lose hair in the spots where your feet or legs hurt. And the pain could be joined by a numb or cold feeling, as well as by changes in skin color.

If you’ve noticed any of these PAD warning signs, you should tell your podiatrist right away. There are easy, non-invasive tests, like the ankle-brachial index, that detect PAD.

Treating PAD

Simple changes like quitting smoking, reducing your alcohol intake and choosing a healthier diet can make a big difference. It’s also important to get more exercise with PAD. While symptoms may worsen when you are exercising, with time you’ll be able to walk longer with less pain. Finally, some individuals with PAD need medication or medical interventions, but a specialist can help with those decisions.


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