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Pathophysiology of obstructive arterial disease.

J D Coffman1

  • 1Department of Medicine, University Hospital, Boston, MA.

Herz
|December 1, 1988
PubMed
Summary

Intermittent claudication occurs when narrowed leg arteries restrict blood flow to muscles. Exercise can worsen this by lowering resistance, making even minor blockages critical for blood supply.

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Area of Science:

  • Vascular Surgery
  • Cardiovascular Physiology

Background:

  • Intermittent claudication stems from arterial stenosis or obstructions, commonly due to arteriosclerosis obliterans.
  • Blood flow and pressure are maintained until arterial narrowing reaches a critical point, leading to a sharp decline.

Purpose of the Study:

  • To explain the physiological mechanisms underlying intermittent claudication.
  • To detail the factors influencing blood flow and pressure dynamics across arterial stenoses.

Main Methods:

  • The study discusses the relationship between arterial radius, blood flow velocity, and peripheral resistance.
  • It examines how exercise, vasodilators, and sympathectomy affect blood flow and pressure drops across stenoses.

Main Results:

  • Non-critical stenoses at rest can become functionally critical during exercise due to decreased peripheral resistance.
  • Arterial occlusions and critical stenoses lead to reduced distal perfusion pressure, exacerbated by exercise and muscle contraction.

Conclusions:

  • Exercise-induced changes in peripheral resistance significantly impact blood flow in patients with arterial disease.
  • The exact stimuli for collateral blood vessel development in response to ischemia remain unclear but may involve pressure differentials and metabolic factors.

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