Peripheral artery disease (PAD): Valerie's story

photo of Valerie Heldman, outside on her deck Playing golf, shopping with her daughter and having tea with her grandchildren are some of Valerie Heldman's favorite things to do. But in April 2005 she worried she might have to limit these activities. Heldman was diagnosed with peripheral artery disease (PAD). [

What is PAD?

Peripheral artery disease (PAD) is one of the most common forms of vascular disease. It is a type of atherosclerosis – hardening and narrowing of the arteries – that occurs in the arteries that supply blood to the arms, neck and legs.

"A heart attack occurs when the arteries supplying blood to the heart become blocked," says Cardiologist Tom Biggs, MD, medical director of the United Hospital Vascular Center.

The American Heart Association estimates that 8 to 12 million Americans have PAD. Several factors can put you at a high risk for developing it:

a family history of heart disease or PAD
diabetes
high cholesterol levels
high blood pressure
being overweight
cigarette smoking

"The same risk factors that make you at risk for heart disease can also make you at risk for PAD. And if you have PAD, you are at increased risk of heart disease and stroke," says Biggs.

In addition, PAD accounts for more than 70 percent of all amputations (removal of a limb or part of a limb).

Symptoms of PAD

Peripheral artery disease (PAD) often occurs in the legs. The typical symptom is aching, cramping pain or fatigue in the leg muscles with walking that disappears with rest. Other symptoms are…

feet that feel cool
loss of feeling in the feet and toes
loss of hair on the tops of your feet
thickened nails
pale, shiny or bluish skin
slow healing of cuts and scrapes

Sudden onset

"I had been shopping with my daughter all day, and the sole of my left foot was killing me," says Heldman. "I took off my shoes, and my foot was blood red in color."

Heldman went to her doctor, Steven Bergeson, at Allina Medical Clinic-Shoreview. He ordered an ankle-brachial index (ABI) for Heldman. The simple blood pressure measurement of the arms and legs is used to find peripheral artery disease (PAD) early on.

In Heldman's case, the ABI results were unclear. So Bergeson referred her to the United Hospital Vascular Center.

Angiogram and angioplasty

At the Vascular Center, Heldman learned that she should have an angiogram to find out if her vessels were narrowing or blocked. During the procedure, a doctor inserts a catheter (a thin, flexible tube) into an artery in the leg, and then injects a small amount of dye. The dye makes the arteries, and any narrowing or blockage, visible on a monitor.

Heldman's angiogram was scheduled for May 3 – until she awoke in extreme pain, and her toes were blue.

"I had my husband, Bob, call the Vascular Center," says Heldman. "Dr. Biggs called me back and moved me up the schedule. I went in for the angiogram on April 22."

The angiogram showed that Heldman’s left femoral artery was 90 percent blocked. So Biggs did an angioplasty. The cardiologist inserted a balloon catheter into the blocked artery to open it. He then put a stent, a small stainless steel mesh tube, in the artery to help it stay open.

After a night in the hospital, Heldman returned home.

Back to normal

"Before the procedure, Valerie was having severe pain just with activities of daily living," says Karen Tennis, RN, Vascular Center lead. "When she came in for a follow-up exam a few weeks later, she was walking 30 minutes, five days a week with no pain."

In addition to regular walks, Heldman takes a daily aspirin, as well as medicine to lower her cholesterol and reduce her risk factors. She has been able to return to her favorite activities.

"I'm back to normal," says the devoted mother of two and grandmother of seven. "After weeks with severe pain, I'm back to doing all the things I enjoy doing."