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Arm Artery Disease
 
This is an abbreviated version of the complete article.*
Basic Facts
Arm artery disease, also called upper extremity arterial disease, is an uncommon type of peripheral artery disease. In this condition, one or more of the arteries that supply blood to the arms and hands becomes blocked.
The disease may involve the large arteries of the arm or the smaller arteries of the forearm or hand.
In contrast to leg artery disease, which is caused primarily by atherosclerosis, arm artery disease is caused by many other disorders.
In arm artery disease, an artery between the chest and the hand becomes partially or completely blocked. Arm artery disease can be acute, meaning that it comes on quickly. However, it is usually chronic, meaning it progresses slowly over a long period of time. In some patients, the disease reduces circulation to the hand but causes no symptoms. Other patients may experience skin ulcers or gangrene because the limb lacks oxygen and nutrients.

WHAT ARE THE SYMPTOMS?

The most common symptom is intermittent claudication, or discomfort, heaviness, tiredness, or cramping in the affected arm, but only when it is being used.

Other symptoms of arm artery disease include:
  • Pain or discoloration;
  • Sensitivity to the cold;
  • Lack of a pulse;
  • Muscle atrophy (wasting);
  • Pale, cool skin;
  • Bluish, slow-growing nails;
  • Slow-growing arm hair;
  • Ulcers (sores); and
  • Gangrene.
CAUSES AND RISK FACTORS

Arm artery disease has several causes. They include:
  • Buerger's disease, also known as thromboangiitis obliterans,
  • Takayasu's disease, an autoimmune disease;
  • Raynaud's phenomenon;
  • Collagen vascular diseases;
  • Atherosclerosis;
  • Thoracic outlet syndrome;
  • Thromboembolism, or when a blood clot travels from one area of the body to another and blocks a blood vessel;
  • Frostbite;
  • Hypothenar hammer syndrome; and
  • Radiation therapy for breast cancer.
Risk factors include cigarette smoking and age over 60.

DIAGNOSIS

To diagnose arm artery disease, a physician will begin by asking about the patient's symptoms and family history of disease. The examination may include:
  • Measuring blood pressure;
  • Feeling for a pulse;
  • Allen's test;
  • Listening to the arteries with a stethoscope;
  • Duplex ultrasound;
  • Arteriogram (also known as angiogram);
  • Segmental blood pressure; and
  • Magnetic resonance angiography (MRA).
TREATMENT APPROACH

Treatments for arm artery disease depend on the cause, location, and severity of the problem, and may include:
  • Cervical sympathetic blockade;
  • Cervical sympathectomy; or
  • Surgical bypass.
If a patient has an underlying condition, such as hypertension or diabetes, treating that condition may improve symptoms of arm artery disease.

LIFESTYLE

Although many treatments are available for arm artery disease, there is no cure. Patients should address risk factors for the causes of the disease by making the following lifestyle changes:
  • Quitting smoking;
  • Eating a healthy diet; and
  • Exercising.
Medical Review Date: June 12, 2009
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