Disease of the Arteries

How it
affects us

By Laura Daniel
 Arm Artery Disease
• Facts
• · Arm artery disease, also called upper extremity disease, is an uncommon
type of peripheral artery disease. In this condition, one or more of the
arteries that supply blood to the arms and hands becomes blocked. The
disease may involve the large arteries of the arm or the smaller arteries of
the forearm or hand.
· Arm artery disease primarily affects cigarette smokers and people age 60
or older.
· In contrast to leg artery disease, which is caused primarily by
atherosclerosis, arm artery disease is caused by many factors.
• In arm artery disease, an artery between the chest and the hand becomes
partially or completely blocked. Arm artery disease can be acute, meaning
that it comes on quickly. However, it is usually chronic, meaning it
progresses slowly over a long period of time. In some patients, the disease
reduces circulation to the hand but causes no symptoms. Other patients
may experience skin ulcers or gangrene because the limb lacks oxygen and
nutrients.
 Causes and risk factors
• A primary cause of arm artery disease is atherosclerosis, or hardening in the arteries.
• However, arm artery disease has several causes. They include:
· Buerger’s disease, also known as thromboangiitis obliterans,
· Takayasu’s disease, an autoimmune disease;
· Raynaud’s phenomenon;
· Collagen vascular diseases;
· Thoracic outlet syndrome;
· Thromboembolism, or when a blood clot travels from one area of the body to another and
blocks a blood vessel;
· Frostbite;
· Hypothenar hammer syndrome; and
· Radiation therapy for breast cancer.
• Arm artery disease primarily affects cigarette smokers and people older than 60. Other
risk factors include:
· Age;
· Heredity;
· Male gender;
· White race;
· Diabetes mellitus;
· High cholesterol; and
· High blood pressure.
 Diagnosis

• To diagnose arm artery disease, a physician will

begin by asking about the patient’s symptoms
and family history of disease. The examination
may include:
· Measuring blood pressure;
· Feeling for a pulse;
· Listening to the arteries with a stethoscope;
· Duplex ultrasound;
· Arteriogram (also known as angiogram);
· Segmental blood pressure; and
· Magnetic resonance angiography (MRA)
 Treatment

• Treatments for arm artery disease depend on

the cause, location, and severity of the problem,
and may include:
· Cervical sympathetic blockade;
· Cervical sympathectomy; or
· Surgical bypass.
• If a patient has an underlying condition, such as
hypertension or diabetes, treating that condition
may improve symptoms of arm artery disease.
Arm Artery Disease
Different parts of arm
 Brachial Artery
• The brachial artery is the major blood vessel of the upper
arm.
• It is a continuation of the axillary artery beyond the lower
margin of teres major muscle. It continues down the ventral
surface of the arm until it reaches the cubital fossa at the
elbow. It then divides into the radial and ulnar arteries which
run down the forearm. In some individuals, the bifurcation
occurs much earlier and the ulnar and radial arteries extend
through the upper arm. The pulse of the brachial artery is
palpable on the anterior aspect of the elbow, medial to the
tendon of the biceps, and, with the use of a stethoscope and
sphygmomanometer (blood pressure cuff) often used to
measure the blood pressure.

• CODE:747.3
 Brachial Artery
• The brachial artery is closely related to the
median nerve; in proximal regions, the
median nerve is immediately lateral to the
brachial artery. In more distal regions, the
median nerve crosses the medial side of
the brachial artery and lies anterior to the
elbow
 Ulnar artery

• A large artery brancing from the brachial

artery, supplying muscles in the forearm
wrist, and hand. Arising near the elbow, it
passes obliquely in a distal direction to
become the superficial palmar arch. It has
9 branches: 4 in the forearm, 2 in the wrist,
and 3 in the hand.
• CODE: 414.0
 Peripheral Artery Disease (PAD)
• Your arteries carry blood rich in oxygen and nutrients from your heart to the rest of
your body. When the arteries in your legs become blocked, your legs do not receive
enough blood or oxygen, and you may have a condition called peripheral artery disease
(PAD), sometimes called leg artery disease.
• The aorta is the largest artery in your body, and it carries blood pumped out of your
heart to the rest of your body. Just beneath your belly button in your abdomen, the
aorta splits into the two iliac arteries, which carry blood into each leg. When the iliac
arteries reach your groin, they split again to become the femoral arteries. Many smaller
arteries branch from your femoral arteries to take blood down to your toes.
• Your arteries are normally smooth and unobstructed on the inside but, as you age, they
can become blocked through a process called atherosclerosis, which means hardening
of the arteries. As you age, a sticky substance called plaque can build up in the walls of
your arteries. Plaque is made up of cholesterol, calcium, and fibrous tissue. As more
plaque builds up, your arteries narrow and stiffen. Eventually, enough plaque builds up
to reduce blood flow to your leg arteries. When this happens, your leg does not receive
the oxygen it needs. Physicians call this leg artery disease. You may feel well and still
have leg artery disease or sometimes similar blockages in other arteries, such as those
leading to the heart or brain. It is important to treat this disease not only because it may
place you at a greater risk for limb loss but also for having a heart attack or stroke.

• CODE: 443.9
 What are the symptoms?
• You may not feel any symptoms from peripheral artery disease at first. The
most common early symptom is intermittent claudication (IC). IC is
discomfort or pain in your legs that happens when you walk and goes away
when you rest. You may not always feel pain; instead you may feel a
tightness, heaviness, cramping, or weakness in your leg with activity. IC
often occurs more quickly if you walk uphill or up a flight of stairs. Over time,
you may begin to feel IC at shorter walking distances. Only about 50
percent of the people with leg artery disease have blockages severe enough
to experience IC.
• Critical limb ischemia is a symptom that you may experience if you have
advanced peripheral artery disease. This occurs when your legs do not get
enough oxygen even when you are resting. With critical limb ischemia, you
may experience pain in your feet or in your toes even when you are not
walking.
• In severe peripheral artery disease, you may develop painful sores on your
toes or feet. If the circulation in your leg does not improve, these ulcers can
start as dry, gray, or black sores, and eventually become dead tissue (called
gangrene).
 Treatment
• Angioplasty and stenting
• In some cases of peripheral artery disease, your physician may recommend
angioplasty and stenting. This procedure is considered to be minimally
invasive in comparison to open surgery. It is most effective for more
localized blockages in the larger arteries. In an angioplasty, your physician
inserts a long, thin, flexible tube called a catheter into a small puncture over
an artery in your arm or groin. The catheter is guided through your arteries
to the blocked area. Once in place, a special balloon, which is attached to
the catheter, is inflated and deflated several times. The balloon pushes the
plaque in your artery against your artery walls, widening the vessel. In some
circumstances, your vascular surgeon may then place a tiny mesh-metal
tube, called a stent, into the narrowed area of your artery to keep it open.
The stent remains permanently in your artery. After this procedure, blood
flows more freely through your artery. Other devices, such as atherectomy
catheters, are currently being developed and are under evaluation to
determine their effectiveness.
Bypass Surgery
 Carotid Artery
• The carotid arteries are two large blood vessels
that supply oxygenated blood to the large, front
part of the brain. This is where thinking, speech,
personality, and sensory and motor functions
reside. You can feel your pulse in the carotid
arteries on each side of your neck, right below the
angle of the jaw line.

• CODE: 424.99
 Symptoms
• You may not have any symptoms of carotid artery
disease. Plaque builds up in the carotid arteries
over time with no warning signs until you have a
transient ischemic attack (TIA) or a stroke.
• Signs of a stroke may include:
• sudden loss of vision, blurred vision, or difficulty in
seeing out of one or both eyes
• weakness, tingling, or numbness on one side of
the face, one side of the body, or in one arm or leg
• sudden difficulty in walking, loss of balance, lack
of coordination
• sudden dizziness and/or confusion
 Treatment
• To effectively treat carotid artery disease,
doctors recommend the following:
• following recommended lifestyle habits
• taking medications as prescribed
considering a procedure to improve blood
flow, if your doctor believes it could help
 Hardening of the Artery
• Hardening of the arteries, is a major cause
of heart attack and stroke. A smoking habit
speeds up the pocess of hardening of the
arteries. Quitting smoking and adopting a
lowfat diet can improve your health.

• Code: 348.8
Hardening of the Artery
• If these coronary arteries become hardened,
degenerated and clogged with lipids (fatty deposits), as
in atherosclerosis, they cannot expand properly to supply
increased blood to the heart during times of exertion.
The agonizing pain of angina stops the victim from all
exertion and tells him something is wrong with the
coronary arteries. Diet, drugs like amyl nitrite, reduced
exertion, and surgery to increase blood supply to the
heart all assist in preventing recurrence.
• Here too is the source of the lay term coronary for a kind
of heart attack, namely a myocardial infarction or
occlusion.
• Information was taken from
• Reviewed By: Alan Berger, MD, Assistant
Professor, Divisions of Cardiology and
Epidemiology, University of Minnesota,
Minneapolis, MN. Review provided by
VeriMed Healthcare Network. Also
reviewed by David Zieve, MD, MHA,
Medical Director, A.D.A.M., Inc.
•
THE END