Heart & Vascular Specialists of Oklahoma
Rakesh Shrivastava MD, FACC • Venkat Rajaram MD, MS
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Peripheral vascular disease (PVD) is the term used to describe diseases of the arteries and veins located outside the heart and brain. There are many causes of PVD, and doctors often interchange the term Periferal Artery Disease (PAD) -  a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis.

What is Atherosclerosis?
When hard cholesterol substances (plaques) accumulate in the walls of the arteries, a patient is said to have Atherosclerosis. Cholesterol plaque causes the walls of the arteries to harden and contribute to a narrowing of the inner channel. It often begins early in life- even in the teenage years- and may not cause any symptoms, so many adults are completely unaware that they have cholesterol plaque building up in their arteries. As people with atherosclerosis age, the build up and narrowing up of the arteries reduces the blood and oxygen flow. 

As atherosclerosis progresses, the restricted blood and oxygen flow can negatively impact many organs. The heart muscle can become weakened, leading to angina and heart attack When the carotid and cerebral arteries (arteries that supply blood to the brain) are narrowed, the possibility of stroke or ischemic attack can be possible.  Advanced atherosclerosis in the legs can lead to pain while walking or exercising (claudication), deficient wound healing, and leg ulcers. Atherosclerosis often effects the arteries throughout the body. Therefore, patients with heart attacks are also more likely to develop a stroke or vascular disease- and vice versa.

Atherosclerosis Treatment
Therapeutic lifestyle changes are key. Adopting a diet that is rich in whole grain cereals such as whole bran and whole wheat, key fruits and vegetables, and legumes such as kidney beans and black eyed peas can make dramatic changes. A healthy diet also includes some types of fish, such as salmon, tuna (canned or fresh), and mackerel. These fish are a good source of omega-3 fatty acids. These acids may help protect the heart from blood clots and inflammation and reduce the risk for heart attack. Try to have about two fish meals every week. Limiting salt is also key.

If your disease progresses, you may require a lab procedure, such as Angioplasty or Stent placement. Sometimes surgical intervention is required.

What Is Deep Vein Thrombosis?
Deep vein thrombosis (throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when blood thickens and clumps together. Although it generally occurs in the upper leg, thigh or in the lower leg, they can also form in other parts of the body.

Of course, the danger of DVT is when a blood clot in a deep vein  breaks off, it can travel through the bloodstream to other organs or get lodged in an artery that is already narrowed because of PAD.  The loose clot is called an embolus (EM-bo-lus). It can travel to an artery in the lungs and block blood flow. This condition is called pulmonary embolism (PULL-mun-ary EM-bo-lizm), or PE.  A pulmonary embolism is a very serious condition that requires immediate attention. Blood clots in the upper leg are more likely to erupt and cause PE than blood clots in the lower legs or other parts of the body. 

DVT Treatment
The goal for DVT treatment has many focuses. First, we want to make sure the clot does not continue to grow or break off and travel to a vital organ. Secondly, we want to make sure that we can reduce the swelling associated with DVT and prevent it from reoccuring. Blood thinners are a standard of care when dealing with blood clots. There are a variety of blood thinners your doctor may use,and each come with their own instructions and considerations.