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Peripheral Arterial Disease
Peripheral Arterial Disease, or PAD, is a very common condition but this may be the first time you've ever heard of it. Dr. Mina Guerges discusses PAD, who is most likely to develop it, possible symptoms, and more.
Featured Speaker:
Mina Guerges, MD, RPVI
Dr. Mina Guerges is an Attending Vascular Surgeon who received his bachelor’s degree from the University of South Florida and his MD degree from Ross University School of Medicine. He completed his General Surgery residency at St. Joseph Mercy Hospital in Pontiac, Michigan, and his Vascular Surgery fellowship at Staten Island University Hospital/Northwell. Dr. Guerges serves as a military surgeon in the US Navy Reserves and is an active NYPD trooper surgeon. Transcription:
Peripheral Arterial Disease
Caitlin Whyte: Peripheral arterial disease is a very common condition, but you probably haven't heard this name before. So today, we are diving in and learning more about this circulatory condition with Dr. Mina Guerges, a vascular surgeon at Jamaica Hospital. This is Jamaica Hospital Med Talk. I'm your host, Caitlin Whyte.
Well, hello, Dr. Guerges. Thank you so much for joining us today to discuss peripheral arterial disease. Before we begin, can you explain to our audience what this is?
Mina Guerges, MD, RPVI: Yes, Caitlin. Thank you very much for having me today. It's a very good question. And it's a very common disease. So basically, it's when the blood flow is reduced to your extremities, either your arms or your legs. Most commonly, when we talk about peripheral arterial disease or PAD, we talk about the legs. So basically, the blood vessels, which are the tubes in the body that carry the blood to all of your organs, they get narrowed or diseased, and that limits the blood flow to your legs, and so you're having trouble at that point keeping up with the demand.
Caitlin Whyte: Okay. So who is most likely to develop PAD? Is there a link to any other medical conditions?
Mina Guerges, MD, RPVI: Absolutely. It's more so social habits and medical conditions. As a matter of fact, the most common cause of peripheral arterial disease is smoking. Other medical conditions that can cause that is high blood pressure, diabetes, high cholesterol. These are what we call risk factors and these are the most common risk factors that cause and aggravate PAD or peripheral arterial disease.
Caitlin Whyte: So then, how does someone know if they have PAD? What are some of the symptoms?
Mina Guerges, MD, RPVI: So basically, when you're walking or you're exercising or you're running, or you're climbing stairs, you start having cramps, especially in your calves. That is one of the most common signs of PAD. And you pretty much know when you're walking half a block, a block, two blocks, and you start having cramping in your calves and then you stop and it gets better. That is a very common telltale sign of that disease process.
Caitlin Whyte: And then, on that note, is it possible to have PAD and not have any symptoms?
Mina Guerges, MD, RPVI: Yes. So people can have very early signs of PAD and they may not develop narrowing enough for them to develop symptoms. But as a surgeon, besides doing surgery on the vessels in your body, one of my main focus is how to prevent it. So I want to increase awareness of peripheral arterial disease so that patients don't wait until they actually develop symptoms. But the answer to your question is definitely yes, people walk around with PAD without having symptoms. It's just a matter of controlling your risk factors, so you don't develop symptoms.
Caitlin Whyte: Well, on this theme, you know, everyone at some point might experience a circulatory issue. How would we then know the difference between a normal everyday issue or PAD?
Mina Guerges, MD, RPVI: So it's a very good question, but it's all kind of intertwined. So when patients develop circulatory issues, they most likely already have PAD. And so that's a very common thing to have. So people with PAD, they not only have blood flow limitation to their legs, they also have blood limitations to their heart, to their blood vessels to the brain. So if you have circulatory issues in general, you're most likely already developing PAD.
Caitlin Whyte: I'd love to focus on wounds for a moment. Can you explain the relationship between wounds and circulation?
Mina Guerges, MD, RPVI: Yes. So now that we know what circulation issues in PAD are, you can develop serious consequences from this. One of the most common consequences that patients present with are wounds. So over time, if you're not getting enough blood supply to your legs, you're not only going to have pain, but you are going to start to lose skin and whatever underneath it. Some people develop very serious complex wounds because there's simply not enough blood flow to it. So these wounds will develop and they will have a very hard time healing until you can establish some kind of blood flow.
Caitlin Whyte: So if someone believes they have PAD, they, you know, feel something tightened while walking like you mentioned, what can they do? Who should they see first?
Mina Guerges, MD, RPVI: So when you have peripheral arterial disease and it's recognized, you should seek out referral to the vascular specialist, mainly the vascular surgeon such as myself. My job is to identify the risk factors that you have, identify the degree of the peripheral arterial disease that you have, and then work out treatment options from there.
Caitlin Whyte: Well, let's talk about those treatment options. What is available and how do we know which treatment is right for which patient?
Mina Guerges, MD, RPVI: Yeah. There are different treatment modalities out there, and the list keeps growing as we know more and more about how to treat this disease process. It can start out with simple medications to help increase the blood flow to your legs. And there is minimally invasive options nowadays, where it's called an angiogram. Basically, I go with a needle and a wire, and I try to see where the problem is and I can balloon it open or perform what we call atherectomy, where I pretty much core out the calcium inside of your blood vessels and try to open it up again. And it can be as big as having an open surgery where it's narrowed to a point where you can't open it up by the minimally invasive approach and you have to do a bypass. So there are a lot of treatment options out there and it depends on the degree and it depends on the symptoms that you're having.
Caitlin Whyte: In addition to treatment, as we wrap up here today, doctor, what can someone do to reduce their chances of developing PAD or at least minimize the symptoms?
Mina Guerges, MD, RPVI: Yes. So the biggest thing that I tell patients is to control the risk factors. Stop smoking. Seek out help to control your blood pressure, your diabetes, make sure you're having regular checkups with your primary care physician or your vascular surgeon to make sure that these risk factors are under control. If you have already developed peripheral arterial disease and you've already received treatment, make sure that you're following up with your physician, even after your treatment. The last thing you want is to have a treatment and then stop seeking out help after that and then you're developing new consequences of an uncontrolled disease process. So the biggest thing is to control your risk factors.
Caitlin Whyte: Well, doctor, that's about all the time we have today. Thank you so much for joining us.
To schedule an appointment at Jamaica Hospital, please call 718-206-7001. And for more information about the services Jamaica Hospital offers, visit our website at jamaicahospital.org/podcasts. This has been Jamaica Hospital Med Talk. I'm your host, Caitlin Whyte. Be well.
All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast.
Peripheral Arterial Disease
Caitlin Whyte: Peripheral arterial disease is a very common condition, but you probably haven't heard this name before. So today, we are diving in and learning more about this circulatory condition with Dr. Mina Guerges, a vascular surgeon at Jamaica Hospital. This is Jamaica Hospital Med Talk. I'm your host, Caitlin Whyte.
Well, hello, Dr. Guerges. Thank you so much for joining us today to discuss peripheral arterial disease. Before we begin, can you explain to our audience what this is?
Mina Guerges, MD, RPVI: Yes, Caitlin. Thank you very much for having me today. It's a very good question. And it's a very common disease. So basically, it's when the blood flow is reduced to your extremities, either your arms or your legs. Most commonly, when we talk about peripheral arterial disease or PAD, we talk about the legs. So basically, the blood vessels, which are the tubes in the body that carry the blood to all of your organs, they get narrowed or diseased, and that limits the blood flow to your legs, and so you're having trouble at that point keeping up with the demand.
Caitlin Whyte: Okay. So who is most likely to develop PAD? Is there a link to any other medical conditions?
Mina Guerges, MD, RPVI: Absolutely. It's more so social habits and medical conditions. As a matter of fact, the most common cause of peripheral arterial disease is smoking. Other medical conditions that can cause that is high blood pressure, diabetes, high cholesterol. These are what we call risk factors and these are the most common risk factors that cause and aggravate PAD or peripheral arterial disease.
Caitlin Whyte: So then, how does someone know if they have PAD? What are some of the symptoms?
Mina Guerges, MD, RPVI: So basically, when you're walking or you're exercising or you're running, or you're climbing stairs, you start having cramps, especially in your calves. That is one of the most common signs of PAD. And you pretty much know when you're walking half a block, a block, two blocks, and you start having cramping in your calves and then you stop and it gets better. That is a very common telltale sign of that disease process.
Caitlin Whyte: And then, on that note, is it possible to have PAD and not have any symptoms?
Mina Guerges, MD, RPVI: Yes. So people can have very early signs of PAD and they may not develop narrowing enough for them to develop symptoms. But as a surgeon, besides doing surgery on the vessels in your body, one of my main focus is how to prevent it. So I want to increase awareness of peripheral arterial disease so that patients don't wait until they actually develop symptoms. But the answer to your question is definitely yes, people walk around with PAD without having symptoms. It's just a matter of controlling your risk factors, so you don't develop symptoms.
Caitlin Whyte: Well, on this theme, you know, everyone at some point might experience a circulatory issue. How would we then know the difference between a normal everyday issue or PAD?
Mina Guerges, MD, RPVI: So it's a very good question, but it's all kind of intertwined. So when patients develop circulatory issues, they most likely already have PAD. And so that's a very common thing to have. So people with PAD, they not only have blood flow limitation to their legs, they also have blood limitations to their heart, to their blood vessels to the brain. So if you have circulatory issues in general, you're most likely already developing PAD.
Caitlin Whyte: I'd love to focus on wounds for a moment. Can you explain the relationship between wounds and circulation?
Mina Guerges, MD, RPVI: Yes. So now that we know what circulation issues in PAD are, you can develop serious consequences from this. One of the most common consequences that patients present with are wounds. So over time, if you're not getting enough blood supply to your legs, you're not only going to have pain, but you are going to start to lose skin and whatever underneath it. Some people develop very serious complex wounds because there's simply not enough blood flow to it. So these wounds will develop and they will have a very hard time healing until you can establish some kind of blood flow.
Caitlin Whyte: So if someone believes they have PAD, they, you know, feel something tightened while walking like you mentioned, what can they do? Who should they see first?
Mina Guerges, MD, RPVI: So when you have peripheral arterial disease and it's recognized, you should seek out referral to the vascular specialist, mainly the vascular surgeon such as myself. My job is to identify the risk factors that you have, identify the degree of the peripheral arterial disease that you have, and then work out treatment options from there.
Caitlin Whyte: Well, let's talk about those treatment options. What is available and how do we know which treatment is right for which patient?
Mina Guerges, MD, RPVI: Yeah. There are different treatment modalities out there, and the list keeps growing as we know more and more about how to treat this disease process. It can start out with simple medications to help increase the blood flow to your legs. And there is minimally invasive options nowadays, where it's called an angiogram. Basically, I go with a needle and a wire, and I try to see where the problem is and I can balloon it open or perform what we call atherectomy, where I pretty much core out the calcium inside of your blood vessels and try to open it up again. And it can be as big as having an open surgery where it's narrowed to a point where you can't open it up by the minimally invasive approach and you have to do a bypass. So there are a lot of treatment options out there and it depends on the degree and it depends on the symptoms that you're having.
Caitlin Whyte: In addition to treatment, as we wrap up here today, doctor, what can someone do to reduce their chances of developing PAD or at least minimize the symptoms?
Mina Guerges, MD, RPVI: Yes. So the biggest thing that I tell patients is to control the risk factors. Stop smoking. Seek out help to control your blood pressure, your diabetes, make sure you're having regular checkups with your primary care physician or your vascular surgeon to make sure that these risk factors are under control. If you have already developed peripheral arterial disease and you've already received treatment, make sure that you're following up with your physician, even after your treatment. The last thing you want is to have a treatment and then stop seeking out help after that and then you're developing new consequences of an uncontrolled disease process. So the biggest thing is to control your risk factors.
Caitlin Whyte: Well, doctor, that's about all the time we have today. Thank you so much for joining us.
To schedule an appointment at Jamaica Hospital, please call 718-206-7001. And for more information about the services Jamaica Hospital offers, visit our website at jamaicahospital.org/podcasts. This has been Jamaica Hospital Med Talk. I'm your host, Caitlin Whyte. Be well.
All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions discussed on this podcast.