Vascular Disease: 8 Things Doctors Want You to Know

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    Vascular Disease: Behind the Scenes
    Vascular disease is common in the United States. Vascular disease affects the arteries and veins, as well as the lymphatic system. About 8.5 million people in the United States are living with peripheral artery disease (PAD) alone, one of the more common vascular diseases that affects the arteries. Age is an important risk factor for developing PAD. Up to 20% of adults older than 60 have the condition. Vascular disease rarely occurs on its own. It’s usually related to other conditions, such as high cholesterol or diabetes. Here are some facts about vascular disease that vascular doctors (surgeons) want you to know.

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    1. “The field of vascular medicine is unique.”
    Most medical specialties have doctors on the medical treatment side, like endocrinologists, or in combination with  the surgical side, like cardiologists and cardiac surgeons, and neurologists and neurosurgeons. But vascular medicine only has vascular surgeons for medical and surgical management. “We are the only medical field where we don't have a counterpart medical professional to the surgeons,” explains Kurtis Kim, MD, a vascular surgeon at Mercy Medical Center in Baltimore, Maryland. This means they often work with other specialists, to cover all angles of a patient’s care.

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    2. “Vascular disease is ‘silent.’”
    “When patients have a stroke, they know the stroke symptoms and they go to an emergency room. They know if they have chest pain that radiates to the left arm, that’s a heart attack,” says Kim. “But with vascular disease, a lot of them are silent.” This means damage can occur to the body before the patient is aware there are any problems. “For example, an aortic aneurysm has no symptoms, even if it’s large in size, until it ruptures, which is a catastrophe,” he explains. People who are at risk for aneurysms (such as a family history) should be screened so they can be caught before they rupture.

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    3. “Vascular disease covers a wide variety of conditions.”
    “A lot of times, patients come in to see me to ‘check their circulation’,” says Christine Chung, MD, a vascular surgeon at NYU Winthrop Hospital in Mineola, New York. “They don't know that there are different components to the circulation. There's peripheral arterial disease and venous disease, which are completely separate things. Disease in your arteries could be a potentially limb-threatening situation. Whereas, if you have problems with your [veins], such as varicose veins, treatment may be more of an elective procedure because the condition is not as serious as other vascular conditions.”

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    4. “Not all venous disease is the same either.”
    Vascular disease includes conditions that affect the veins, the blood vessels that return blood to the lungs for oxygenation, but not all venous disease is the same. “A blood clot [in a vein] is different from having leaky valves,” Chung says. While leaky valves can cause pain or discomfort, a blood clot in a vein or a DVT that breaks away can cause a pulmonary embolism, which can be fatal. “The treatment is very different for the patients,” Chung continues. “The prognosis is different.”

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    5. “Peripheral artery disease is often a sign of other conditions.”
    Vascular disease, in particular peripheral artery disease, often tells your doctor there are other problems with your health. “Having peripheral artery disease is almost a marker for other comorbidities that would place patients at higher risk for [death and other diseases],” Chung explains. “A lot of times, if your arteries are involved, your heart is involved, your kidneys are involved, you're a diabetic, you have coronary disease—you have different reasons for why your mortality is higher. These are patients with increased risk, in general.”

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    6. “The older you are, the higher the risk of peripheral artery disease.”
    Older age is a risk factor for vascular disease, particularly peripheral artery disease. This increases if you have diabetes. “Diabetes increases the risk four-fold,” Kim says. “Smokers develop peripheral artery disease about three times more than average. Cholesterol issues certainly contribute as well—they double the risk [of PAD] over the average person who has no cholesterol issues.” It can also run in families. There isn’t a known gene related to PAD, Kim said, but there is definitely a familial aspect to it.

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    7. “Vascular disease is rare in younger people.”
    While there are pediatric vascular surgeons, it’s a rare condition among children. “Most of the pediatric vascular surgeons are pediatric cardiovascular surgeons, so they fix heart defects,” says Kim. “I’ve treated children as young as 13 from a trauma that ruptured a vein,” he explains. “But it’s pretty rare [for a child to develop a vascular problem].”

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    8. “Not all vascular disease needs immediate treatment.”
    “One misconception is that if you have some kind of a circulation issue or an aneurysm or a blockage somewhere that it absolutely needs to be treated, but that's not true,” says Chung. Unless you have symptoms, your vascular doctor may choose to offer medical therapy (medications, if indicated) and then follow your progress. “Just because you have something, it doesn't mean that you need to treat it or that it would even get worse.” Your treatment plan may start with monitoring with noninvasive imaging tests and continuing clinical exams to monitor your health.

8 Things Doctors Want You to Know About Vascular Disease
Contributors

About The Author

Marijke Vroomen Durning, RN, has been writing health information for the past 20 years. She has extensive experience writing about health issues like sepsis, cancer, mental health issues, and women’s health. She is also author of the book Just the Right Dose: Your Smart Guide to Prescription Medications and How to Take Them Safely.
  1. Peripheral Arterial Disease (PAD) Fact Sheet. Centers for Disease Control and Prevention. https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_pad.htm
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Last Review Date: 2021 Mar 20
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