Arteriosclerosis or degenerative arterial disease
Of an arterial origin, the pain is a symptom the presents fluently. The persistent pain is produced with the ulceration and gangrene in the Buerger’s Disease and it may be very critical. In a similar manner, although with less intensity, pain occurs with arteriosclerosis. The numbness, the cold sensation and tingling are very often associated. The sudden beginning of very intense pain may continue with arterial occlusion. The pain from the venous thrombosis is quicker and is accompanied by reddening and sensitivity, above and around the vein affected.
Peripheral arterial disease generally manifests itself with the appearance of intermittent claudication, with pain that is usually produced in the calf muscles when the person suffering from the condition has walked a certain distance. The necessary distance for the pain to appear is called "the claudication distance" and is an indication of the gravity of the affliction.
The color of the skin depends on the amount of blood in it and on the velocity with which it flows. The temperature of the skin is perceived to be better with the hands of the examiner. Warm skin indicates the amount of circulation, and one that is cold, indicates a decrease.
This deals with a degenerative arterial pathology, and therefore, without inflammatory signs.
It is a process that affects the majority of arteries, above all the coronary and cerebral ones.
Arteriosclerosis which affects only the extremities, presents a symptomatology in the beginning vague and rare. Only, later, vascular intermittent claudication leads the patient to see a physician. As the years transpire, the ischemia worsens and collateral circulation becomes insufficient, rest pain transpires, the pain continually is maintained even at rest and there is coldness in the distal region of the affected extremity. This ischemia may be only muscular ischemia or sometimes cutaneous and accompanied even by gangrene. In the lower extremity, this muscular ischemia may give rise to retraction of the corresponding muscles, such as an ankyloses when bending the knees, which is very difficult to correct.
Tests of peripheral circulation
- Oscilometry. The recording machine is an apparatus to measure the amplitud of the arterial pulses in the extremities. Reading it helps to determine the level, of arterial obstruction. Currently this has fallen out for use because of its limited specificity.
- Angiography. The injection of a radiopathic substance the arterial wall, permits the visualization of the artery and the peripheral branches in the place of injection. Angiography is used only if one is contemplating a surgical intervention, because the contrast means have the tendency to produce an arterial spasm and with it to reduce the important collateral circulation.
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