About Peripheral Artery Disease Your Heart and Blood Vessels Your heart is about the size of your fist and shaped something like a pear. The heart pumps blood to every part of your body through pipes called arteries. The blood leaves the heart through a large pipe, the aorta. Smaller and smaller pipes take blood to every cell. As it travels, blood brings oxygen and nutrients to each cell, picking up waste along the way. After the waste is removed by your kidneys and liver, the blood goes back through another set of pipes called veins. The veins carry the blood back to your heart and lungs to get more oxygen, and the trip starts all over again. The heart, arteries and veins together are known as the vascular system. If you are deaf or hard of hearing, please let us know. We provide many free services including sign language interpreters, oral interpreters, TTYs, telephone amplifiers, note takers and written1 materials. Artery Disease Blood flow problems affect your body in different ways: Artery disease refers to blood flow problems that can cause blocked arteries in the heart, brain and other • If arteries in your heart are clogged or blocked, parts of the body. you may have a heart attack or other heart damage. This is called coronary artery disease, or Various things—cholesterol, waste from cells, heart disease. calcium, fatty deposits—can build up in your arteries. This is not unlike the sludge that may build • If arteries going to your brain are clogged or up in the water pipes in your home. blocked, you may have a stroke or other brain injury. This is called cerebral vascular disease. This build-up, known as plaque, is more common as we get older. If there’s too much build-up in an • If arteries going to another part of your body are artery, blood can’t flow through it the way it should. clogged or blocked, you can have pain or damage The body part supplied by that artery may be in that area. In time, it can lead to organ failure, damaged, because it will not get enough oxygen. gangrene (dead tissue) or amputation (surgery to remove a limb). This is called peripheral artery Plaque can also cause a blood clot to form, quickly disease (PAD). closing off the artery. Or, if a piece of plaque breaks off, it may be carried in your blood until it The most serious blood flow problems can completely blocks a smaller artery. cause death. How Artery Disease Progresses Healthy artery Plaque begins to The plaque causes The artery narrows, A clot can form, build up inside the the artery walls to so less blood can cutting off blood artery wall. swell inward, which get through. flow in the artery. restricts blood flow. 2 The basic problem is the same: plaque build-up in • Have problems with cholesterol your arteries. If you have build-up in one part of your body, you are more likely to have it in other • Are overweight or obese parts of your body as well. • Deal with frequent stress Lifestyle changes, such as quitting smoking or being • Have a family history of early artery disease. more active, along with medicine, surgery and other treatments, can help you get better. They also make These are called risk factors. For more about risk it less likely that you will have further problems. factors, see page 14. Who is likely to have blood flow problems? How do I find out if I have blood flow problems? Anyone can have blood flow problems. Research shows that most people already do. As we get older, Some people come to the hospital with chest pain, most of us are likely to get some build-up in our a severe headache or leg cramps—all symptoms of arteries somewhere in the body. artery disease. Others learn they have a problem after a doctor tests them for artery disease. People who are more likely to have blood flow problems: If you think you might have blood flow problems, tell your doctor about your symptoms and family • Smoke, or spend time around tobacco smoke history. If you know you have artery disease in one • Are men, or are women who have been part of your body, ask your doctor about checking through menopause for it in other parts. • Have diabetes • Have high blood pressure • Get little or no exercise How Artery Disease Progresses (Cross-section View) 3 Common Diagnoses Heart Disease (Coronary Artery Disease) Heart attack and angina Coronary artery disease is disease in the arteries A heart attack happens when one of the heart of the heart. Like every other part of your body, arteries is completely blocked. No blood flows to your heart needs fresh blood carrying oxygen and that part of the heart. This usually occurs when a nutrients. The heart gets this blood through the blood clot forms where there is plaque in an artery. heart arteries. These arteries go around the outside of the heart, branching into smaller arteries that go When blood stops flowing to part of the heart, that to different parts of the heart. part will begin to die. This leads to lifelong damage. If plaque builds up in these arteries, it can slow or Angina is pain or pressure in the chest. It is caused block the blood flow to the heart. If blood flow by reduced blood flow to part of the heart. There are to part of the heart is stopped, the heart may have three kinds of angina. lifelong damage. This is an emergency. • Stable angina feels the same each time it occurs. If any part of the muscle is damaged or dies, a scar It may happen when you are more active. When forms. This reduces the pumping power of the you rest, stop your activity or take nitroglycerin, heart. The more damage there is, the harder it is it goes away. for your heart to pump. This leads to pain, fatigue • Unstable angina may come on even when you (feeling very tired), shortness of breath and other are resting. It may be stronger or last longer than symptoms that affect your quality of life. stable angina. If you have had angina in the past, It’s important to get help quickly when you have but now it’s more painful or happening more signs of heart disease. The more time that passes, the often, you may have unstable angina. more your heart muscle may be harmed. • Coronary artery spasm may occur when you’re at rest. This is when one of the heart arteries suddenly squeezes shut or almost shut. During a spasm, less blood—or no blood—goes to part of the heart. This can happen if you have plaque build-up in your arteries. But it can also happen in a normal heart artery. Your doctor will work with you to find out what triggers your spasms. For some people, going out in very cold weather or being under stress can trigger a coronary artery spasm. 4 What are the symptoms? What should I do if I think I’m having a heart attack? Angina and a heart attack have the same symptoms. Angina symptoms are usually short-term, and they • Call 911 if you have any symptoms that might don’t result in lifelong damage. But angina can lead be a heart attack. Don’t wait. Even if it turns out to a heart attack, so it is something you can’t ignore. to be only an upset stomach, it is better to make Symptoms include: an extra trip to the emergency room than to risk lifelong heart damage. • Pressure, tightness, squeezing or burning on either side of the chest, in the middle of the chest • A heart attack often causes symptoms for more or between the shoulder blades than 15 minutes. You may have had warning signs (chest pain or pressure) for days or weeks before • Pain or pressure in the throat, jaw or teeth the heart attack. If you are having a heart attack, • Pain or pressure that spreads to the shoulders, your symptoms often won’t go away when you arms, neck or jaw rest. Any symptoms that don’t respond quickly to rest and nitroglycerin need to be checked. • Tingling, aching or numbness on the inner sides of your arms, elbows or wrists • Don’t drive yourself to the hospital—call 911. The ambulance staff can give you oxygen and • Fainting or feeling light-headed, usually with medicine. These will help with pain and may other symptoms reduce the amount of damage to your heart. The staff can also save your life with electric shocks if • Heartburn or feeling sick to your stomach, your heart stops beating effectively. usually with other symptoms Once at the hospital, your care team will quickly • Cold sweats; unusually heavy sweating work to diagnose the problem. Your history of during activity symptoms, an EKG and blood tests all play a role in • Feeling very tired or far more tired than usual deciding if you have had a heart attack. • Shortness of breath If you have a blood clot blocking a heart artery, you may get clot-dissolving medicine or have an • Sudden, strong anxiety emergency procedure to unblock the artery. • Heartbeats that skip or seem either very fast or very slow, usually with other symptoms. The symptoms may go away for a while and then come back. Pain or a tight feeling in your chest is the “classic” symptom of a heart attack, but not everyone has this symptom.