There are problems with both the heart and leg blood vessels. Can they be solved at once?

81-year-old Grandma Liu (pseudonym) has a history of hypertension and hyperglycemia for more than ten years. Not long ago, Grandma Liu had intermittent palpitations . She thought it was an old problem, and her family and herself did not pay attention to it. A week before the consultation, Grandma Liu's palpitations became more frequent and severe, so she came to our hospital for treatment. After diagnosis, the patient was found to have " unstable angina pectoris " . Angiography showed diffuse stenosis in the middle and distal end of the left anterior descending branch, one of the most important blood vessels of the heart , and the most serious stenosis had reached 95%; the circumflex branch also had 75% stenosis at the distal end. The doctor immediately gave the left anterior descending branch drug balloon dilatation interventional treatment, and the blocked blood vessel was immediately opened.

During the postoperative ward rounds, the director noticed the abnormal temperature and reaction of Grandma Liu's lower limbs . "It's always like this. My calves always feel cold. Sometimes it hurts when I walk, sometimes it doesn't. It's much better when I rest." Grandma Liu's words attracted the attention of the doctor. Combined with the patient's coronary artery vascular disease, the doctor highly suspected that there were problems with Grandma Liu's lower limb blood vessels, so he arranged a color Doppler ultrasound of the lower limb blood vessels. The results confirmed the judgment that Grandma Liu's right lower limb had already developed distal femoral artery stenosis and arterial trunk sclerosis with multiple plaques . No wonder Grandma Liu's calf had such symptoms!

After recovering from the cardiac interventional surgery, the doctor arranged an interventional treatment for Grandma Liu on the right superficial femoral artery, and the drug-eluting balloon dilatation opened up the blood vessel that was 100% blocked.

The "red lights" of the heart and lower limb blood vessels were on at the same time, which meant that if the blood vessels of Grandma Liu were "broken", myocardial infarction, sudden death and other unimaginable consequences could occur at any time . Two hidden dangers were discovered during one visit to the doctor, and the "panvascular disease" was solved in one stop. Before being discharged from the hospital, Grandma Liu and her family were particularly grateful to the medical staff of the first ward of the Department of Cardiology.

From Grandma Liu's medical experience, we may need to pay attention to a concept: pan-vascular disease . In 2023, the American Heart Association (AHA) officially proposed the concept of cardio-renal-metabolic syndrome (CKM), which is defined as a health disorder and a systemic disease caused by the pathophysiological interaction between obesity, type 2 diabetes (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD). These diseases do not exist in isolation, but are a series of dyslipidemia and inflammatory reactions caused by metabolic abnormalities, which damage vascular endothelial cells, promote atherosclerosis, plaque formation and vascular stenosis, the so-called "pan-vascular disease."

In simple terms, panvascular disease is a group of systemic vascular diseases with vascular lesions (95% of which are atherosclerosis) as common pathological features, which mainly harm important organs such as the heart, brain, kidneys, limbs and aorta . It is not limited to a single blood vessel or organ, but involves the whole body vascular system. Patients may have diseases of multiple vascular beds at the same time or successively, such as coronary artery disease, cerebrovascular disease, peripheral artery disease , etc.

Panvascular disease has high morbidity, mortality, and disability rates , and is the leading cause of death among Chinese residents. Multiple blood vessels are involved, and the disease is more complicated, more difficult to treat, with a greater economic burden and a worse quality of life.

To address these hazards, early panvascular disease management is needed.