Recognizing early signs of vascular disease — and why timing matters
By Jenny Peterson
When it comes to vascular disease, the body often sends signals long before a serious diagnosis is made. The challenge is knowing what to look for — and acting on it early.
Vascular conditions generally fall into two categories: arterial disease, which affects blood flow from the heart to the body, and venous disease, which impacts the return of blood back to the heart. While both can significantly affect quality of life, their symptoms, and consequences, can differ.
Arterial Disease Warning Signs
One of the earliest and most telling signs of arterial disease occurs in the legs.
Patients may notice cramping, fatigue or tightness in the calves, thighs or buttocks when walking and those symptoms immediately ease with rest. This condition, known as claudication, is caused by reduced blood flow and oxygen to the muscles, causing them to essentially seize up.
“Patients can often tell you exactly how far they can walk before pain starts, whether it’s to the mailbox or around the block, and once they stop walking, it immediately goes away,” said Dr. Gerald Fortuna, a vascular surgeon with Coastal Vascular & Vein Center with six locations statewide. “Then, patients walk that same distance again and symptoms return.”
Other warning signs can be more subtle: pale or cool skin, slow-healing wounds, hair loss on the legs, brittle toenails, or sensations like numbness and tingling. As the condition progresses, symptoms may intensify to include pain at rest — sometimes waking patients from sleep — or the development of nonhealing wounds, signaling severely compromised blood flow.
“Diabetics are familiar with the pins and needles feeling in their extremities from neuropathy, but you can get those same kinds of feelings from not having enough blood flow,” Dr. Fortuna said.
While age and genetics play a role, lifestyle factors remain some of the most significant contributors to arterial vascular disease. Smoking, sedentary habits and a diet high in processed foods and sugars can damage the lining of blood vessels, triggering inflammation and plaque buildup.
“The process starts with injury to the vessel lining,” Dr. Fortuna said. “Over time, that leads to narrowing of the arteries.”
The good news is that early intervention can slow progression and significantly reduce risk. Regular exercise, smoking cessation, and dietary changes — particularly adopting a Mediterranean-style diet — can all support vascular health. Managing chronic conditions like diabetes is equally critical.
“That’s something we do every day,” Dr. Fortuna said. “When people start to experience problems with the arteries in their arms and legs, that’s often a marker for disease in the heart and carotid vessels as well.”
Early Vascular Evaluation
That’s where specialized vascular care can make a difference, not just in treating symptoms, but in identifying broader risks. Patients don’t always need a referral to seek evaluation, and early screening with just an ultrasound can be key.
“A big benefit of our outpatient center is that we can help patients with screening processes earlier and we can also help be an early detector of heart disease and causes of stroke,” Dr. Fortuna said.
Venous Disease and Circulation
On the venous side, which is even more common and where genetics play a large role, symptoms can include leg heaviness, swelling, aching, restless legs, and visible varicose or spider veins. These issues are often dismissed as cosmetic or minor, but they can signal underlying dysfunction in the veins’ valves, leading to poor circulation over time.
Unlike arterial disease treatments, where vessels are opened to improve flow, venous treatments often involve closing malfunctioning veins to redirect blood into healthier pathways.
Many of these procedures are minimally invasive and performed in-office, with little downtime.
Advancements in vascular care have expanded treatment options dramatically. From clot removal techniques to stenting and vessel repair, today’s approaches focus on restoring circulation while minimizing recovery time and returning legs to their previous appearance.
Why Timing Matters
Still, timing remains everything.
“In early stages, we can manage and improve symptoms relatively easily,” Dr. Fortuna says. “But as disease progresses, interventions become more complex and sometimes the focus shifts to limb salvage.”
In regions like the Southeast, where rates of diabetes and vascular complications are higher, access to specialized care can play a critical role. Delayed treatment can lead to preventable outcomes, including amputation.
Dr. Fortuna’s takeaway is simple: don’t ignore the signs.
Whether it’s leg pain when walking, unexplained swelling, or wounds that won’t heal, these symptoms are worth investigating. Early evaluation not only improves quality of life, but it can also uncover and prevent more serious health risks down the line.
