Other Vascular issues

If You Have Other Vascular Problems
- Understanding Your Condition7596OtherVascularIssues
- Vascular Diseases Risk Assessment
- Monitoring Your Health

Did you know:

• 20 million to 30 million Americans are at risk for some type of vascular diseases right now, according to estimates from the American Vascular Association?
• Vascular diseases (like strokes and aortic aneurysms) cause almost as many deaths and disable as many people as heart disease?

Southeast Alabama Heart & Vascular Center is here to help keep you from becoming part of this deadly trend.

We have only one focus: you.

1) We help you determine your risk for vascular diseases
2) We identify your medical problems using our advanced diagnostics capabilities 
3) We provide the full range of treatments you need 
4) We work with you to rebuild your health and quality of life for the long term

Call today and take the first steps to protecting yourself – and the people you love – from the deadly impact of vascular diseases.

If you live in southeast Alabama, northwest Florida, and southwest Georgia, this short trip could be life saving - please call (334) 793-8143.

Southeast Heart and Vascular Center is located at Southeast Alabama Medical Center
1108 Ross Clark Circle, Dothan, Alabama
Outpatient Tower - 3rd Floor

Understanding Your Condition

Has your doctor warned you about your risk for stroke?
Do you have diabetes, high blood pressure or high cholesterol?
Is your lifestyle unhealthy – no exercise, fatty foods, smoking or excessive drinking?
Ever have excessive cramps in the legs?

You may be at risk for vascular diseases – a group of conditions that can leave you weakened, disabled or even cause death:
- What is vascular disease?
- Peripheral artery disease (PAD)
- Peripheral vascular disease (PVD)
- Abdominal aortic aneurysm (AAA)
- Stroke/carotid artery blockage

The good news: if you understand the signs and symptoms to watch for, make good lifestyle choices – and get prompt, comprehensive, sophisticated medical care (like the care provided at the Southeast Heart and Vascular Center) – you can be treated successfully.

Take a few minutes to learn the basics about theses conditions. And then find out how the Southeast Heart and Vascular can help you.

What Is Vascular Disease?

Vascular disease is the broad terms for conditions affecting your circulatory system – your arteries, veins, lymph nodes and even your body's ability to circulate blood. Poor circulation means your body cannot function properly, blood cannot transport vital oxygen, and you are at greater risk for heart attack, stroke, kidney failure and a host of other problems.

Vascular disease is silent in its early stages and its symptoms often go undiagnosed and untreated until a health problem or crisis comes up. Vascular disease does not go away on its own, and requires expert medical care.

Some of the most common vascular diseases are:
• Peripheral artery disease (PAD)
• Peripheral vascular disease (PVD)
• Abdominal aortic aneurysm (AAA)
• Stroke/carotid artery blockage

Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD) is caused by clumps of plaque that build up in one or more arteries in the extremities of the body, such as the legs. PAD affects nearly 10 million adult Americans according to the American Heart Association.

Symptoms

• As the inside of the artery "clogs" from the plaque, the space where the blood can flow gets smaller and blood flow slows down. The symptoms you may have depend on what artery is affected and how severely the blood flow is reduced:
Claudication (dull, cramping pain in hips, thighs or calf muscle)
• Infection/sores that do not heal
• Ulceration or gangrene

Having any of the following risk factors may increase your chance of developing PAD:
• Diabetes (one of the effects of diabetes is damage to blood vessels in the legs and feet)
• Smoking
• Being overweight
• High blood pressure
• High cholesterol
• A family history of PAD
• Lack of exercise
• Coronary artery disease
• Being older than 65

Diagnosing PAD

To detect PAD, you may have tests such as:
• Ankle Brachial Index (ABI)
• Doppler Ultrasound Test
• CAT Scan or MRI
• Angiogram

Treatment

Many treatments can be used to improve blood flow through the peripheral arteries. They bring relief, often require no more than an overnight hospital stay, and you can usually return to your normal activities quickly.
• Angioplasty and stents - different tiny devices, such as balloons in angioplasty, are inserted into the blocked artery and expanded to increase the vessel's opening. Stents are small metal "tubes" that stay in the artery to hold it open.
• Atherectomy - removing blockages using miniature cutting systems
• Bypass surgery - if a vessel is extensively blocked, surgery may be used to reroute blood flow around the problem area.
• Exercise - while not appropriate for every PAD patient, exercise – if approved by your doctor - may improve arterial blood flow to the affected area.)
• Stop smoking - smoking causes decreases the diameter of blood vessels, which can interfere with adequate blood flow to the limbs.
• Medications – Medications prescribed to patients with P A D include antiplatlet medications (such as aspirin and Plavix), those that increase blood flow (Cilostazol (Pletal)) or cause vasodilation (calcium channel blockers such as Amlodipine or Verapamil).

Thoracic-Abdominal Vascular Disease and Aneurysm

The thoracic abdominal area includes the aorta and the renal arteries or arteries in the kidneys. The most common type of vascular disease in this part of the body is aneurysm.
• Aneurysms can occur in any blood vessel in the body, but the most common type arises in the largest artery in the body—the aorta.
• This condition affects over 200,000 Americans and is referred to as an Abdominal Aortic Aneurysm (AAA).
• An AAA is a very serious condition that claims the lives of 15,000 Americans every year.
• As the aneurysm grows, it weakens the artery wall and may rupture or leak. Should this occur, affected individuals might go into shock and die as the result of massive internal bleeding.
• Early detection of AAA can lead to treatment to prevent a rupture.

Symptoms

Abdominal Aortic Aneurysm (AAA) is often referred to as the "silent killer," as most people do not have symptoms. However, a heightened awareness and suspicion for the presence of AAA should exist in the following situations:
• AAAs are most common in people over the age of 60.
• 70 – 80 percent of AAA cases are in males; however, as more women are diagnosed with cardiovascular disease, this statistic is changing.
• High blood pressure, smoking and high cholesterol levels have all been shown to increase the risk of developing an AAA.
• 20 percent of people with AAA have a family history of either cardiovascular disease or aneurysms.
• While there are usually no symptoms, pain in the abdomen or back that is not explained by a known medical condition, or a pulsating in the abdomen (for example, when reading a book that is resting on the abdomen, the book moves up and down) could suggest the presence of an AAA and should be evaluated by a physician immediately.

If you have one or more of the above risk factors, you may be a candidate for screening tests that can detect an AAA early so it may be properly treated.

Diagnosing AAA

Aneurysms may be detected during a routine physical examination.
• Your physician may feel pulsations while pressing on your lower abdomen.
• If you are at risk to have an aneurysm, due to family history, high blood pressure, high cholesterol, old age, etc., the following imaging studies may be performed:
o Abdominal Ultrasound
o Computed Tomography (CT) Scan

Treatment

Once an aneurysm is diagnosed, your physician will determine the appropriate treatment depending upon its size and location.
• If the aneurysm is small, your physician will likely monitor its growth with repeated ultrasound or CT imaging.
• If it is large or appears to be growing rapidly, treatment may be required.
• Open Abdominal Surgery: This approach involves direct replacement of the aneurysm with a synthetic artery. The surgeon repairs the aneurysm and sews a synthetic graft (manmade replacement artery) in its place.
• Endovascular Intervention: Some patients may be candidates for a minimally invasive alternative. The endovascular approach requires small incisions in the groin. A graft attached to a catheter is threaded through your arterial system until it reaches the location of the aneurysm. The graft is left in place to prevent the aneurysm from growing by keeping blood pressure away from the arterial walls. Not all individuals are candidates for this minimally invasive alternative.

Neurovascular Disease and Stroke

The most devastating complication of neurovascular disease is stroke. A stroke usually occurs when the flow of oxygen rich blood to the brain is suddenly interrupted. There are two types of stroke:
• Ischemic stroke, which is caused by the blockage of an artery to the brain; or
• Hemorrhagic stroke, which is caused by a sudden rupture of a brain artery, leading to bleeding into or around the brain. Both forms of stroke may result in permanent brain damage or even death.

Symptoms

If you or a friend experience symptoms of a stroke, it is important to call 911 and receive immediate treatment:
• Difficulty feeling or moving on one side of the body
• Difficulty speaking or understanding others
• Temporary or permanent loss of vision in one eye, or partial loss of vision in both eyes
• Dizziness or extreme lightheadedness

Diagnosing Stroke

The best way to prevent stroke is to identify your risk factors and to treat them. This can be done through a simple risk assessment examination.
• You are at increased risk of stroke if you smoke tobacco; suffer from high blood pressure, diabetes, high cholesterol, obesity; or have other evidence of atherosclerotic arterial disease.
• If you are found to be at high risk for stroke, your physician may arrange for you to undergo additional testing, including:
o Carotid Duplex Scan (ultrasound)
o Magnetic Resonance Imaging (MRI)
o Cardiac echocardiography
o CT angiography
o Magnetic Resonance Angiography (MRA)

Pre-Stroke Treatment

• If you are found to suffer from a blockage of your carotid arteries (an artery in the neck that is the major blood supply to the brain), you may benefit from either carotid artery surgery or carotid artery stenting.

Vascular Diseases Risk Assessment

1) Your Potential Risk

The team at the Southeast Alabama Heart & Vascular Center is committed to give you outstanding treatment. Our detection program can help catch the most common forms of vascular disease early on so that treatment can be given before a crisis occurs.

Take a minute and answer these important questions:
• Are you 50 years old or older?
• Are you under 50 years of age and currently overweight or diagnosed with pre-diabetes?
• Do you have a family history of heart, vascular disease or stroke?
• Do you have high cholesterol or are you taking medication for high cholesterol?
• Do you have high blood pressure or are you taking medication for high blood pressure?
• Are you diabetic?
• Have you ever had a stroke?
• Are you currently a smoker or a former smoker?

If you answered "yes" for one or more of these questions, our peripheral vascular disease (PVD) screening could be ideal for you. Our PVD screening includes three tests for:

• Peripheral arterial disease (PAD) – We use a blood pressure cuff and ultrasound device to measure blood circulation in your legs to determine if the arteries there are blocked by plaque.

• Abdominal aortic aneurysm (AAA) – We do an ultrasound test of your abdominal aorta (the major blood vessel between your heart and legs) to look for weaknesses in the vessel's walls.

• Stroke – Our ultrasound test looks for narrowing or blockage caused by plaque in the carotid arteries of your neck that can lead to strokes.

The tests are noninvasive and painless, taking only about 30 minutes to complete. You don't even have to undress! In addition, this screening provides you with a benchmark for your vascular health so that you can monitor any changes from year to year.

After Your Screening

• A surgeon and radiologist review the results.
• A final report, along with recommendations is mailed to you and your primary physician (if requested by you) in approximately 1-2 weeks.
• If your test indicates you are at high risk for vascular disease, we contact you to schedule a follow-up appointment for more in-depth testing.

Cost of Screening

• Peripheral vascular disease screening is not covered by insurance.
• Please contact us to discuss the cost of your screening package. Credit cards and checks are accepted. Payment can be made when making an appointment over the phone or upon check-in.

Book your screening today - please call (334) 793-8143 or toll free 1-800-507-7262.

2) Your Diagnosis

Our sophisticated diagnostic technology allows our physicians to identify, treat and manage all types of vascular diseases affecting your head and neck, arms, legs, abdominal organs, heart and circulatory system – often using techniques that don't require entering your body!

Our noninvasive vascular laboratories are equipped so that we can take advantage of sophisticated ultrasound techniques. By using specially focused sound waves we can "see" your blood vessels and evaluate how well blood is flowing through them or if there are disruptions or blockages. Once we see an immediate picture of how severe your problem may be we can begin working with your doctor to plan the most effective treatment.

The various ultrasound techniques not only identify problems quickly, they are also free of the risks and discomfort associated with injections, X-rays or other invasive procedures. Best of all, with almost no risks these tests can be done safely and frequently over time to track your progress and how your disease is responding to treatment.

This summary shows the ultrasound procedures we perform regularly and the types of problems they can reveal:

Peripheral arterial disease (blockages in arteries of the arms or legs due to arteriosclerosis - "hardening of the arteries" - or other diseases
that may threaten the health of the limbs) • Doppler arterial exams
• Duplex ultrasound scan
• Treadmill exercise testing for claudication (leg pain while walking)
Cerebrovascular disease (blockages in arteries leading to the brain, increasing the risk for stroke) • Carotid artery duplex scan
Deep venous thrombosis ( blood clots in veins that can move into the lungs and cause death) • Venous duplex scan of arms or legs
• Inferior vena cava (IVC) scan
Renal artery disease (arterial disease of the kidneys that can cause high blood pressure or kidney failure) • Renal artery duplex scan
• Duplex scan of the renal veins
Mesenteric arterial disease (disorders of circulation to the gut) • Mesenteric duplex scan
Aortic aneurysms (a "ballooning" of the major artery in the heart that can rupture and cause death) • CT scan
• Aortic duplex scan
• Duplex scan of peripheral arteries for aneurysms

3) Your Treatment

Once testing determines the type of problem you're facing, the Heart and Vascular Center's skilled specialists will then talk with you and your doctor about the options for immediate and long-term treatment. Treatment may include (either alone or in combination):
• Minimally invasive treatments
• Non-invasive surgical therapies
• Surgical treatments
• Drug therapy
• Compression therapy for chronic disorders

Read more about the advanced treatment facilities and services available to you.

Minimally invasive treatments • Angioplasty (reopens blocked blood vessels
• without surgery)
• Stent treatments (tiny metal mesh tubes are inserted after angioplasty in some cases to keep blood vessels open)
• Lytic therapy (dissolves clots through injection of special medicines)
• Placement of endografts (stents that can open narrowed arteries or be inserted into aneurysms to prevent rupture)
• Inferior vena cava filter placement and retrieval (used to keep clots in deep vein thrombosis from reaching the heart or lungs)
• Mechanical declotting (of arteries and veins)
• Vascular embolizations
• Laser atherectomy (to remove dangerous plaque that can block arteries and lead to strokes, heart attacks and other dangerous conditions)

Surgical Treatments

• Endarterectomy of neck arteries (removing plaque buildup to prevent strokes)
• Vein excision (to treat painful varicose veins)
• Aneurysm repairs (in the aorta and other major arteries)
• Bypass grafts (for blocked arteries in abdominal organs, arms and legs)
• Re-operative surgery (to treat previous graft failures and save limbs)

Monitoring Your Health

Risk assessment, diagnosis and treatment at the Heart & Vascular Center are only a portion of your overall treatment plan.

You can monitor your health and take proactive steps to lower your risk for vascular disease or for a recurrence of problems:

• Quit smoking – Smoking causes serious damage to the vascular system, including contributing to constriction and hardening of the arteries.
• Control cholesterol - Lowering your cholesterol levels through diet and possibly medication can also help reduce your risks for having a vascular event, such as a heart attack or stroke.
• Control diabetes – If you're diagnosed with diabetes, make sure that your blood sugar level is well controlled, because uncontrolled blood sugar can actually accelerate the rate at which you develop vascular disease.
• Exercise and diet – Follow a regular aerobic exercise program, maintain a healthy weight, and eat a balanced diet that includes plenty of vegetables and fruit and is low in saturated fats.