¨Heavy legs¨ are one of the most specific symptoms among human afflictions. Except in rare occasions, they are only induced by exercise and alleviate rapidly with its interruption. Claudication indicates always an insufficient blood supply to the muscles in contraction. It appears exclusively in the cases of chronic occlusive arterial disease or arteriospastic disease, in which the blood is diminished and as a consequence oxygenation is deficient.
Generally, the symptoms with which patients present range from muscle cramps, tightness, fatigue, even feeling pain. It is customary that fatigue preceeds the pain and even though in the beginning it can be mute, it can become acute. This usually begins in the calf, by propagating, itself in the muscle above and below. In the region of the foot, from the ankle and the heel, the pain is of a different type, it can be described as a sensation such as walking barefoot on a rocky terrain.
Of arterial origin, pain is a symptom that presents consequently. Persistent pain is produced with the ulceration and gangrene in Buerger´s Disease and may be very grave. In a similar manner, although with less intensity, the pain occurs in arteriosclerosis. The numbing coldness and tingling are associated with each other very often. The sudden beginning of a very intense pain may continue with arterial occlusion. The pain of venous thrombosis is very fleeting and is accompanied by redness and sensitivity above and around the affected vein.
Peripheral artery disease generally is manifest with the appearance of intermittent claudication, with pain that is usually produced in the muscles of the calf when the patient has walked a certain distance. The distance needed for 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 supply of blood in it and on the velocity with which it flows. The temperature of the skin is perceived to be greater with the hand of the examiner. Hot skin indicates an increase of circulation and one that is cold, a decrease.
Los problemas circulatorios de origen arterial en las piernas se sitúan en los vasos de la circulación de salida del corazón hacia las extremidades, contrariamente a los de origen venoso que hemos visto hasta ahora, que se refieren a la sangre que está camino de vuelta hacia el corazón.
Tests os Peripheral Circulation
- Oscilometry: The oscilometer is an aparatus for measuring the width of the arterial pulses in the extremities. The reading helps to determine the level of arterial obstruction. It has currently fallen into disuse because it is of limited specificity.
- Angiography: The injection of a radiopaque substance in the arterial wall permits the visualization of the artery and the peripheral branches at the site of injection. Angiography is used only if a surgical intervention is contemplated, as the contrasts have the tendency to produce an arterial spasm and to reduce with it important collateral circulation.
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