What kind of doctor do you see for vascular problems?
Vascular problems can be managed by primary care doctors, specialized surgeons, and radiologists that are trained in performing procedures. These two specialists are known as vascular surgeons and interventional radiologists. Which of these specialists you would see varies greatly based on your medical history and what treatments have already been tried by your primary care doctor.
Why would you see a vascular specialist?
Most people end up being referred to a vascular specialist for a condition that causes pain. Pain as a result of poor blood flow is known as “claudication.” Claudication will temporarily get worse when the area of the body that has the vascular problem is used. It may feel like a cramping, burning, or numbness in the affected area. The presence of claudication is often the first symptom of peripheral vascular disease, a condition that results from blockages in the blood vessels that lead to the organs and limbs.
Claudication occurs most commonly in the legs and is made worse by walking. Claudication may also occur in the stomach and is usually made worse with eating. As vascular issues become more severe they may lead to symptoms such as:
- Weakness of the legs
- Painful ulcers on the toes
- A change in the color of the legs
- Bright red bleeding from the rectum after eating
- Severe pain that does not go away even with rest
There are other vascular conditions besides claudication that may be evaluated by a vascular specialist. The most common of these are varicose veins, worm-like veins in the legs that result from blood pooling in the legs. Some patients have these treated due to pain, while others choose to treat or remove them because of cosmetic appearance.
What is included in a peripheral vascular assessment?
A peripheral vascular assessment is focused on the area of the body that is suspected of having poor blood flow. In the majority of cases, this is the legs. A vascular specialist will perform a physical examination that is similar to the one done at any routine doctor’s visit. They will also perform special tests using a blood pressure cuff and a machine designed to reveal the speed at which blood is flowing through the arteries in the feet. This test only causes a light pressure sensation that feels similar to having your blood pressure checked.
For more severe symptoms a vascular specialist will often order imaging tests known as angiograms that allow them to see the structure of the blood vessels. This lets them determine the severity of obstruction in the arteries, blood clots in the veins, and any other vascular issues.
What doctor treats peripheral vascular disease?
Peripheral vascular disease is treated in three stages–lifestyle changes, medical treatment, and surgical treatment.
Lifestyle changes are the best treatment for mild vascular disease in the arms or legs. Your primary care doctor will recommend daily exercise and physical therapy which increases blood flow to the areas of claudication and can significantly reduce pain over time. All other treatments for peripheral vascular disease are ineffective without the addition of exercise.
Next, your primary care doctor will prescribe medical treatments if symptoms continue despite daily exercise. In the case of claudication, these medications are taken by mouth and can help the blood vessels to dilate and allow a greater amount of blood flow to the arms and legs. Other vascular conditions have few medical treatments and may be managed with compression stockings and physical therapy.
Surgical treatment is the last resort for peripheral vascular disease. If exercise and medications both fail, your primary care doctor will refer you to a vascular surgeon to determine if surgery is a good option for you.
Do cardiologists treat vascular disease?
Yes, but they only treat vascular disease of the heart, not vascular disease that affects the stomach, arms, or legs. If you have not already seen a cardiologist and are being treated for peripheral vascular disease, your primary care doctor will refer you to a cardiologist. This is because almost all patients with peripheral vascular disease also have vascular disease in the arteries of the heart.
What is the difference between peripheral vascular disease and peripheral artery disease?
Peripheral artery disease is a specific form of peripheral vascular disease. Arterial disease is the most common type of vascular disease that leads to specialist referral as it causes severe symptoms.
There are some common vascular diseases, such as varicose veins, telangiectasias (spider veins), and temporary poor blood flow in the hands (Raynauds). These conditions rarely require specialist treatment and typically only cause mild symptoms.
