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I have a poor blood circulation in left leg/foot

I am a 39 year old woman with no personal history of cardiovascular disease and blood pressure in the normal range (but my father has had several heart attacks, TIA s, and one major stroke that occurred while he was having an angiogram- left hem; approximately Broca s area). I recently began a full-time college teaching position, and have begun suffering acutely from occasional stress-related insomnia , combined with lack of sleep simply due to work load... this seems related to other symptoms that seem like panic attacks, along with the general (sometimes intense) discomfort that goes along with fatigue. In the last few weeks I noticed that sometimes my left big toenail becomes blue, but it recovers its (more) normal shade after I rub my feet and legs or warm up in the shower. Could this be a sign of cardiovascular issues? Is the left lateralization significant?
Asked On : Tue, 8 Feb 2011
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Thoracic Surgeon 's  Response
POOR CIRCULATION can occur in any area of the body. The two areas most prone are the upper and lower extremities. For now we will be discussing the lower extremities, and the onset of this disease and how to cope with the condition as it progresses.

The most common manifestation of poor circulation is caused by Venous Thrombosis, more commonly known as Thrombophlebitis. This is an acute disease, usually, self limiting and lasting from 1 to 2 weeks. The symptoms generally are tenderness, a warmish feeling, bluish discoloration, pain, accumulation of fluid (edema), and a distention of the superficial veins that affect the groin, buttock, and lower abdomen and thigh areas.

When the acute phase is over, the painful symptoms usually are abated. The initial acute attack causes injury to the epithelium or inner liner of the vein resulting in venous thrombosis or blockage of the vein. Symptoms at this chronic stage are, pain or soreness when standing or walking and relieved only on rest and elevation of the leg. There can be tenderness over the calf and the patient complains of a feeling of fullness in the lower leg.

Anyone experiencing these or the above symptoms must see their physician to be examined and evaluated. An evaluation may require different tests, such as a venogram, Isotope venography, Plethysmography or Doppler ultrasound. When the condition is definitively diagnosed, the physician will decide on the proper treatment. Blood thinners may be the treatment of choice of which there are several. In conjunction with this treatment, he will most likely advise being fitted for an elastic below the knee stocking which should be worn from the time you get up in the morning to bedtime.

The condition can become serious if left untreated and the results can be disastrous. A venous stasis occurs, causing a pooling of blood that stagnates in the lower limb. The formation of varicose veins further complicates the condition. The leg aches, and will feel hot and tired. These symptoms are somewhat relieved by the compression hosiery and elevation of the leg. Wrapping the leg with an elastic bandage is not advisable because it is difficult to wrap evenly and it may be too tight. It will also have a tendency to slip.
Answered: Tue, 8 Feb 2011
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