Pain in the calf muscles, cold feet, increased sensitivity to changes in temperature conditions of the environment, intermittent claudication - this is not a complete list of characteristic symptoms that indicate the presence of a formidable disease. This disease is called obliterating endarteritis and leads, with incorrectly chosen tactics of treatment, to amputation of the lower extremities. And this pathology after the amputation of the foot quickly spreads through other blood vessels. Such patients are most often demented from acute heart failure on the background of coronary obliteration of the vessels. The obliterating endarteritis of the lower extremities most often affects men after the age of 50 years. Predisposing factors are alcoholism, tobacco smoking, non-compliance with diet, concomitant diseases of the cardiovascular system, high cholesterol in the blood, sedentary lifestyle. Recently, with the help of scientific studies, data have been obtained that the obliterating endarteritis of the limbs develops under the influence of a high level of the hormone of testosterone in the peripheral blood of a person. This male sex hormone, with an excess of which patients lose their hair on the scalp, abundantly overgrow with vegetation on their face, have a rough bass and are highly aggressive. It is the increased testosterone level in the male's blood that explains the prevalence of this disease among the stronger sex.
In women, the obliterating endarteritis of the extremities also occurs, but much less frequently. They are at risk of getting sick ladies who do not differ in their increased resistance to stressful situations. At them pathological narrowing of blood vessels against a background of a spasm of smooth muscles occurs under the influence of another hormone - adrenaline or noradrenaline. This substance in large quantities is thrown into the blood with a strong fright, experience, during a stressful psychological situation. His "mite" in the formation of the prerequisites for the emergence of obliterating endarteritis in women introduces multiple artificial termination of pregnancy, in which hormonal "scrap" occurs and for "neutralizing" oxytocins, prolactin and other estrogens, "male" testosterone is released in huge quantities.
Endarteritis of the lower extremities and its etiology
The endarteritis of the lower limbs is a systemic pathology in which the muscular wall of small blood vessels suffers. Basically, at the initial stage, the capillaries suffer, through which peripheral arterial blood, enriched with oxygen and nutrients, enters the subcutaneous fat, epidermal and muscle layers. At the first stage, the vasospasm is short-lived and is accompanied by a sharp onset of a tingling sensation in one or both feet. The attack quickly passes, and the patient forgets about it for a while. However, after a while the clinical picture is repeated with redoubled force. In this case, one can already say that the arteriolar lesion began and the progressive stenosing process will soon stop the flow of blood through the arteries.
Prolonged absence of nutrients and oxygen in the tissues of the foot and lower leg leads to the development of a necrotic dying process. First there are trophic ulcers that do not respond to any treatment, then gangrene develops. In this situation, an emergency amputation of the foot or shin is a necessity for saving a person's life.
The etiology of endarteritis development has been well studied. It is a pathological process, which includes several leading stages in the formation of complete overlapping of the arterioles or capillaries:
- primary spasm against the background of the hormonal component;
- decrease in the rate of blood flow through the spasmodic area;
- sediment of leukocytes, lymphocytes and other cells of the immune system in the area of spasm;
- development of the primary inflammatory process with the phenomenon of total swelling of the muscular wall of the blood vessel;
- further narrowing the capillaries and arterioles and forming in them small thrombi that can completely block the access of blood to the peripheral tissues of the foot and lower leg.
Symptoms of obliterating endarteritis
Typical symptoms of obliterating endarteritis include typical complaints of patients with a vascular surgeon. These may be the following features:
- frequent causeless cramps in the calf muscles of the legs, especially often they occur at night and are often mistakenly diagnosed as restless leg syndrome;
- increased sensitivity of the feet to the cold - legs freeze even in properly selected shoes for the season;
- pain in the feet and calf muscles during physical exertion;
- often causes a sensation of numbness of the limbs, especially in the sitting position;
- quickly appears intermittent claudication: a person can not climb to the floor without rest or pass a certain distance without stopping.
As the pathology develops, the symptoms of endarteritis become visible with the naked eye:
- the volume of the subcutaneous fat layer in the field of golovye and stop is reduced;
- the skin becomes dry and flabby, looks like papyrus paper;
- pale skin with a bluish tinge;
- feet are always cold and can become covered with a sticky sweat.
As the pathological changes increase, bruises and bruises appear in various parts of the shins. Gradually, trophic changes are growing. Begin to appear trophic ulcers, which at the initial stage look like small abrasions and cracks. However, the wound surface rapidly increases. Secondary pathogenic microflora is attached. An abscess develops, which can hardly be treated with antibacterial drugs.
Diagnosis of endarteritis
Currently, the diagnosis of endarteritis is not difficult in any medical institution. Enough external examination, in which the doctor determines the weakening or lack of pulsation on the artery located on the inner and the outer side of the foot in the ankle.
To confirm the diagnosis and differential diagnosis of endarteritis, angiography with contrast agent and fluoroscopy, Doppler ultrasound scanning, capillarography, computed tomography and much more can be used.
Treatment of obliterating endarteritis of the lower extremities
Modern medicine offers patients only symptomatic treatment of endarteritis. This is due to the fact that there are no radical and specific methods for reverse development of the pathology of small blood vessels. Perhaps, only to slow down the progressing development of the disease and keep the patient able to move on his feet, avoiding amputation of the limbs.
Treatment of obliterating endarteritis includes several directions:
- elimination of pain syndrome by relieving spasm of small blood vessels; antispasmodics are used for this;
- increased blood flow with painful areas: Trental, Pentoxifylline, nicotinic acid, xanthinal nicotinate, Detralex and many other drugs are used;
- provides sufficient tissue trophy by increasing the content of vitamins in the peripheral blood: injections of vitamin preparations are used;
- measures are being taken to reduce the level of platelet aggregation and blood viscosity;
- obliterating endarteritis treatment;
- treatment of the obliterating endarteritis of the lower extremities.
Recently, a high degree of effectiveness shows the drug "Angiotropin" - it is recommended to take months of regular courses. Also, a daily intake of acetylsalicylic acid is prescribed as an antiaggregant pharmacological agent.
The physical culture and therapeutic massage is of great importance in the treatment of the obliterating endarteritis of the lower limbs. It is necessary to ensure regular regular loading on the shins and feet for the development of muscle fiber and stabilization of the state of the vascular wall. Massage should be combined with baths, which may contain locally irritating substances. An excellent means of topical application is tincture of red hot pepper. It includes a substance that eliminates the spasm of small blood vessels and restores the elasticity of the vascular wall.