Leg Pain Can Mean Heart Danger, Expert Says

David Dow thought he was having back problems, and that his legs were hurting as a result. As it turns out, that pain may have saved his life.

An otherwise healthy 57-year-old, he figured he just needed to learn some back-strengthening exercises, so he found a personal trainer to help him. But despite the workouts, his leg pain got worse making it hard for him even to walk from the car to the grocery store entrance. He and the trainer suspected something else was wrong and he sought the advice of his doctor.

Soon his doctor's tests revealed the true cause: blockages in the blood vessels of his legs. In fact, the arteries going to his lower extremities were nearly 100 percent blocked. The cause? Years of heavy smoking and high-fat meals, and other factors had caused cholesterol, scar tissue and blood clots to build up inside his blood vessels.

Most people think this kind of clogged artery disease, or arteriosclerosis, only happens in the heart. But as Dow's case shows, it can happen throughout the body. When it does, it's called peripheral arterial disease, or PAD.

And in some people, PAD causes leg pain that acts as an 'early warning' that someone is at high risk for a heart attack or a stroke, says a University of Michigan Cardiovascular Center expert.

"This is the hallmark of a disease that's all over," says James Stanley, M.D., a director of the U-M CVC and the vascular surgeon who operated on Dow. "It's like gray hair you don't just get it on one side of your head. So if you've got this kind of blockage in your leg, you're going to have it other places."

In fact, nearly a quarter of people who have leg pain due to PAD will be dead in five years, mostly due to heart attacks and other heart problems, Stanley says. For people like Dow, whose leg pain kept them from walking even short distances, the odds are even worse: as many as half will die by five years.

Fortunately, Dow got diagnosed and treated before that happened to him. Stanley performed a bypass operation to open his blocked leg arteries, similar to the bypasses that heart patients have. A recent checkup showed he's doing well.

"For sure, it's a wake-up call," says Dow, who has quit smoking and changed his eating habits. "You know that old saying, 'Where there's smoke, there's fire'? I'm sure that I not only have the vascular issues in my lower extremities, but I'm sure I have them in other parts of my body."

Dow isn't alone, says Stanley, who has operated on thousands of patients with severe PAD in his decades as a professor of vascular surgery at the U-M Medical School. Nearly 30 million people in the United States have some form of PAD, though the vast majority are "silent" cases that don't cause symptoms. Among people over age 70, nearly one person in five has PAD.