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Circulatory disorder: causes, symptoms, therapy
SOS - acute circulatory disorder
Acute circulatory disorder may occur without any prior indication. The cause is often a vascular occlusion. In this case, action must be taken very quickly. Otherwise the consequences can be life-threatening. The emergency doctor or an ambulance should be called immediately. The risk of having a heart attack or a stroke is greatly increased in this situation. Immediate action must also be taken against the lack of blood circulation itself.
These symptoms can be signs of a vascular blockage:
- pale skin on the affected area
- lack of pulse in the affected arm or leg
- Decrease in body temperature in the affected area
What does circulatory disorder mean?
A circulatory disorder is when the blood vessels are no longer sufficiently permeable to allow the necessary amounts of blood to pass through. As a result, the surrounding tissue of an artery is no longer supplied with sufficient oxygen and nutrients. With a blocked vein, harmful metabolic products can no longer be completely removed from the cells. An incipient circulatory disorder often goes unnoticed at first. Only when the inadequate supply or the blood congestion have reached a certain point do more pronounced symptoms arise.
Circulatory disorders can lead to functional restrictions and damage to organs and muscles. In the worst case, the body tissue that has been cut off from the blood flow dies. Circulatory disorders can occur in all areas of the organism. Strokes and heart attacks are feared because brain cells and heart muscles are particularly sensitive to an undersupply. Many older people also suffer from circulatory disorders in the extremities. Especially common in the legs. The cause is usually arteriosclerosis (hardening of the arteries), which narrows the veins.
An important difference is which vessels cause a circulatory disorder. If a vessel leading away from the heart, i.e. an artery, is blocked, the consequences for the patient are different from those of a vein leading to the heart.
Circulatory disorder - symptoms
The initial symptoms of a circulatory disorder are often overlooked. After all, completely healthy people can also have cold feet or hands at times, for example. But if the symptoms appear more and more often, a circulatory disorder may be behind it. If symptoms persist or recur, medical advice should be sought. Indications of a circulatory disorder or an occlusive disease can be:
- pale areas of skin
- delayed wound healing
- cold limbs
- no palpable pulse
- limited endurance when running
Arterial circulatory disorders
If the arteries show constrictions or even occlusions, one speaks of arterial occlusive diseases. The patients suffer from an inadequate supply of the tissue behind the affected blood vessels.
Chronic arterial occlusion usually develops from progressive arteriosclerosis (hardening of the arteries). The blood flow is increasingly obstructed by deposits in the arteries. So-called intermittent claudication is a prime example of the consequences of arteriosclerosis. Initially without symptoms (stage I), later with typical symptoms. Due to the inadequate blood circulation, the muscles of the legs tire very quickly and begin to hurt (stage II). Those affected have to take short breaks while walking (for example in front of shop windows on the way) before they can go on again. The doctor diagnoses PAOD in the following cases: peripheral arterial disease. As the PAD progresses, the symptoms also occur at rest. In stage IV PAOD, the arteries are completely blocked. If left untreated, it is mainly superficial areas of tissue on the leg that die off. Ulcers and open legs (non-healing wounds) can occur. If it deteriorates further, there is a threat of amputation of the leg.
It is not just the legs that can be affected by PAOD. Peripheral arterial disease can also occur in the arms or hands. Often the internal organs also suffer from an inadequate or no blood supply due to arterial occlusive disease. Coronary artery disease is then often diagnosed, in which the heart muscle is not properly supplied with blood. Vascular occlusions also occur in the brain or other organs. In mild cases, the body is able to take over the supply by forming new blood vessels. These natural self-healing powers reach their limits in the case of serious illnesses.
Venous circulatory disorders
The blood vessels that lead back to the heart may also have insufficient permeability or be completely closed. Then not only the reliable removal of metabolic products from the cells is at risk. In addition, a thrombosis can form in the narrowed vessels. A clot of blood becomes stuck and obstructs or prevents the flow of blood (embolism). The thrombosis often shows up in the legs or arms. The limbs swell as a result and are very sensitive to pressure. In some cases, the affected area becomes red and hot, with symptoms similar to those of inflammation. Any pain that occurs is relieved by elevating the extremities.
In the event of a thrombosis, it is essential to inform the doctor or, ideally, to drive straight to the hospital. The blood clot in the vein can loosen, migrate around the body and lodge in vital organs such as the lungs.
Circulatory disorders - causes
In addition to arteriosclerosis and embolism, vascular inflammation can also cause circulatory disorders. So-called vasculitis can result from vascular injuries or the harmful effects of medication. Some patients have vascular inflammation as a result of an autoimmune disease. Certain risk factors increase the likelihood of a circulatory disorder.
Risk factors for the development of circulatory disorders:
- Sedentary lifestyle
- high blood pressure
- unbalanced diet
- high cholesterol
- Cardiovascular diseases
Circulatory disorder - diagnosis
If a circulatory disorder is suspected, the doctor will ask about the nature of the symptoms and inquire about previous illnesses. Diseases of the cardiovascular system and metabolic diseases are particularly relevant here. If there is a circulatory disorder in the extremities, the blood pressure is measured on both halves of the body in order to determine any differences between the affected and the healthy side. If necessary, measurements are also taken on the upper arm and lower leg in order to calculate the ankle-arm index (Doppler index). If the ankle-arm index is below 0.9, there is probably a circulatory disorder in the leg.
In the next step, the doctor usually takes blood to check the values for coagulation factors, enzymes, cholesterol and blood sugar. Using Doppler sonography (ultrasound), he observes the direction and speed of the blood flow. Oscillography shows whether the pressure differences caused by the pumping of the heart muscle in the veins are still sufficiently pronounced. The diseased blood vessels can be shown in an X-ray image using angiography. A narrow point (stenosis) can thus be clearly located. If possible, a stress measurement is also helpful. This shows the severity of the disease on the route that the patient can walk at a certain pace without pain.
Circulatory Disorder - Treatment
Acute circulatory disorders are medical emergencies. Prompt treatment is therefore urgently needed. Various surgical procedures are possible.
An existing clot of blood can be removed under local anesthesia (embolectomy). In addition to the surgical removal of the vascular occlusion, there are other treatment methods. Drug dissolution of the clot using blood thinning agents can free the vessels. In vascular dilatation, a constricted blood vessel is mechanically stretched with a balloon catheter and often held open with a support (stent).
In addition to agents that promote blood circulation, there are also drugs available that alleviate the symptoms of the circulatory disorder:
- Painkillers such as ibuprofen or, if the pain is more severe, opiates relieve the symptoms of circulatory disorders.
- Prostaglandins and plasma expanders stimulate blood flow.
- Antiplatelet agents prevent platelets from clumping together and thin the blood.
Light physical activity improves the oxygen supply to the whole body. These include walking, swimming and cycling. Physical exercise and targeted physiotherapy also stimulate the organism to form new vessels that can partially take over the supply of tissues with poor blood circulation.
In addition to the physiotherapy mentioned above, spa treatments can also help against possible symptoms of circulatory disorders. These include, for example, carbonic acid baths and warm water treatments for the arms.
What can you do yourself against circulatory disorders?
Gentle endurance sport can help improve blood flow to the affected parts of the body. Cycling, swimming and walking are recommended. Obesity should be reduced as much as possible. You should completely refrain from smoking, because nicotine and cigarette condensate promote circulatory disorders. A healthy and balanced diet is more important than in previous life. Elevated blood lipids can have a negative impact on the disease. In diseases of the fat and carbohydrate metabolism or high blood pressure, the therapy instructions of the doctor should be strictly followed.
Homeopathy for circulatory disorders
Homeopathic remedies are used to support circulatory disorders in order to strengthen the body as a whole. The prescriptions of the homeopath must always be discussed with the attending physician in order to avoid possible contraindications. The choice of homeopathic therapeutic agent is based on the specific complaints associated with the circulatory disorder (selection):
- Kreosotum: in connection with weeping, poorly healing ulcers, with burning pain and itching
- Espeletia: for circulatory disorders in the legs, such as peripheral arterial occlusive disease (PAD)
- Secale cornutum: for poor blood circulation and numbness as well as painful narrowing of the small vessels on fingertips and toes
- Tabacum: for numbness and tingling in arms and legs in connection with ice-cold fingers, hands, feet and toes
- Cuprum arsenicosum: for tingling, numbness and sensory disorders in the legs, especially in the lower legs and cramps in the calves and the soles of the feet
Acupuncture for circulatory disorders
Acupuncture is said to have a circulation-promoting effect. In this respect, the treatment with the fine needles could have a positive influence on the development of a circulatory disorder. The Far Eastern therapeutic method could represent a supplement to conventional medical treatment approaches. A trained acupuncturist will offer a suitable form of therapy during the consultation. The aim of the treatment is, in the sense of the holistic approach of Traditional Chinese Medicine (TCM), to restore a balance of the energy flows in the body.
Circulatory disorders in the elderly
Elderly people have a greatly increased risk of circulatory disorders. Many clinical pictures in connection with insufficient blood supply to the extremities, such as open legs and intermittent claudication (PAD) or coronary heart disease, are considered typical age-related ailments. Other diseases, which occur more frequently in old age, promote circulatory disorders. These include, in particular, high blood pressure, diabetes and arteriosclerosis. At an advanced age, however, illness is by no means an inevitable fate. A healthy diet with regular physical activity can usually have a positive effect on the course of the disease.
Circulatory disorders in pregnancy
In pregnant women, there may be insufficient blood flow to the placenta. In severe cases, the disease leads to inadequate care for the unborn child. That is why the attending physician routinely pays attention to the normal function of the placenta. As with other circulatory disorders, diabetes and high blood pressure are considered risk factors for circulatory disorders. There is also an increased risk of thrombosis in pregnant women. This is due to the changed hormonal balance during pregnancy, which has a significant effect on blood clotting and the elasticity of the veins. Wearing compression stockings can reduce the risk of thrombosis.
Hypertension - ICD Code
In medicine, every illness is assigned its own ICD code. The abbreviation ICD stands for International Statistical Classification of Diseases and Related Health Problems. The classification system is recognized worldwide and one of the most important for medical diagnoses. "Other peripheral vascular diseases" are recorded under the ICD code "I73". Entering this code often helps with research on the Internet.
Circulatory disorders - What does the health insurance company pay for and what do you have to pay for yourself?
Members of a statutory health insurance basically have the right to inpatient and outpatient care, to drugs and other services. As a rule, however, certain personal contributions (additional payments) are stipulated by law. These additional payments amount to 10 percent of the costs, but a maximum of 10 euros per additional payment. If the service costs less than 5 euros, the insured person must pay the actual price.
These limits also apply to pharmaceuticals. If the person concerned receives a particularly inexpensive preparation, there is no additional payment. The health insurances can determine fixed amounts that they reimburse if several preparations with the same active ingredient are available. Medicines, the price of which is 30 percent below this fixed amount, are reimbursed by health insurance companies without additional payment.
In addition, there is a regulation that the statutory health insurance no longer has to reimburse the individual price of the respective drug for certain preparations, but only the fixed amount that has been set for a group of comparable preparations. If the prescribed medication is more expensive, the patient has to pay the additional price himself plus the statutory additional payment for the reimbursed portion of the costs.
Co-payments also apply in the event of a hospital stay. They amount to 10 euros per calendar day, whereby the additional payment only has to be made for a maximum of 28 days per year. Several hospital stays can be combined in one year, so that the maximum additional payment for inpatient treatment is 280 euros per calendar year.
In the case of home nursing, ten euros are due for the prescription. In addition, a personal contribution of 10 percent per day is to be paid. The co-payment is limited to 28 calendar days per calendar year and is only charged for adults over 18 years of age. The upper limit of EUR 280 per calendar year also applies to home care. Co-payments for hospital stays count towards the cap on co-payment for home nursing.
If the costs for household help are covered by the health insurance, the insured must make an additional payment of 10 percent of the costs incurred. The limits are at least 5 and a maximum of 10 euros per calendar day. This co-payment obligation applies to the entire period in which domestic help is used.
In the case of aids, the insured must make an additional payment of 10 percent of the selling price, with an upper and lower limit of 10 and 5 euros per prescription.
The amount of co-payments for rehabilitation measures depends on the measure and the respective cost bearer.
The costs for pain therapy in a pain clinic are usually covered by any statutory health insurance company, as it is a contracted medical service. However, additional costs (such as additional payments for prescriptions) may arise privately.
The costs of a classic body acupuncture are covered by all statutory health insurances for chronic pain in the lumbar spine or knee osteoarthritis. It is assumed that the pain has existed for at least six months.In such cases, legally insured persons are entitled to up to ten acupuncture sessions per case of illness within a maximum of six weeks. A new treatment can take place no earlier than twelve months after completion of the last acupuncture treatment. The health insurance will only reimburse the costs if the treatment is carried out by a qualified doctor. Acupuncture from a naturopath is not accepted. The costs are then to be paid privately.
Circulatory disorders - what does the DFV take care of?
The outpatient supplementary health insurance DFV-AmbulantSchutz reimburses you for additional payments provided for by law for medicines, bandages, remedies and aids and travel costs as part of outpatient treatment. The DFV-AmbulantSchutz also offers you extended pension benefits and is also there to support you financially if a serious illness is diagnosed.
In the event of illness, with the additional hospital insurance DFV-KlinikSchutz Exklusiv, you do not wait longer than 5 days for an appointment with a specialist doctor.
You also benefit from head physician treatment, a single room, free choice of hospital and daily hospital allowance for an inpatient clinic stay. DFV-KlinikSchutz makes you a private patient in the hospital including international health insurance.
FAQ about circulatory disorders
How does a circulatory disorder develop?
Often it is a clot of blood or a narrowing in a vein or artery that is obstructing blood flow. The area behind this obstruction in the artery is no longer adequately supplied with blood. In the case of a vein, however, blocked blood can no longer flow out properly. Circulatory disorders can also occur more rarely as a result of vascular spasms or vascular inflammation. Circulatory disorders must be treated promptly in order to avoid consequential damage.
How do you recognize a circulatory disorder?
The signs of an arterial circulation disorder are pale skin, numbness, cold extremities, barely palpable pulse and pain. The fingertips or toes may turn bluish in color. In contrast, if the vein is partially or completely blocked, the affected area feels more hot and inflamed. The skin is often reddish in color. The pain that occurs decreases when the arm or leg is raised.
Does physiotherapy help against circulatory disorders?
Regular exercise reduces the risk of circulatory problems. Active physiotherapy and moderate endurance sports are therefore helpful. A targeted sports program can lead to a demonstrable improvement in the insufficient blood flow in the presence of circulatory disorders. Certain movement sequences stimulate the formation of new blood vessels in the organism, which reconnect the affected parts of the body to the bloodstream.
To which doctor if you have a circulatory disorder?
In the event of a slight circulatory disorder, the doctor's office should be used as soon as possible. In the case of an acute vascular occlusion, however, the emergency doctor must be informed immediately or the transport to the hospital arranged. The risk of life-threatening consequences is high. The treating specialist is then often a vascular surgeon, internist or angiologist.
Why can diabetes lead to circulatory disorders?
Diabetes mellitus damages the blood vessel walls. This applies to both the fine hair vessels (capillaries) and the large veins in the heart. Deposits settle on the damaged vessel walls. Blood clots can then form more easily in the narrowed veins and arteries, which further obstruct the flow of blood. Circulatory disorders set in.
- German Society for Angiology Society for Vascular Medicine e.V. (DGA), www.dga-gefaessmedizin.de, (accessed January 12, 2021)
- National Association of Statutory Health Insurance Physicians, health information: Circulatory disorders of the legs, www.kbv.de, (accessed on January 12, 2021
- Professional Association of German Internists, www.internisten-im-netz.de (accessed on January 13, 2021)
- S3 guideline on peripheral arterial occlusive disease (PAD), available at leitlinien.dgk.org (accessed on January 13, 2021)
- Mitteldeutscher Rundfunk: Dangerous circulatory disorders, the "intermittent claudication", www.mdr.de, (accessed on January 13, 2021)
- HalloVita Verlag, www.hallo-homoeopathie.de (accessed January 12, 2021)
- German Acupuncture Society: www.deutsche-akupunkt-gesellschaft.de (accessed on January 13, 2021)
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