Peripheral vascular disease: what did Elizabeth II suffer from?

According to an Australian doctor, Queen Elizabeth II who died on September 8 may have suffered from peripheral vascular disease, also called 'obliterating arteriopathy of the lower limbs' (PAD). What is that ? What symptoms? Treatments? Explanation with our cardiologist.

According to Dr Deb Cohen-Jones, Australian doctor interviewed by the English site Dailymail , Queen Elizabeth II who died on September 8, 2022 may have suffered from a peripheral vascular disease, also called 'peripheral arterial disease' or ' obliterating arteriopathy of the lower limbs' (AOMI) in France. The pictures of marbled hands of the Queen taken during her meeting with the new British Prime Minister Liz Truss at Balmoral Castle in Scotland on Tuesday September 6 were according to this doctor a 'sign of declining health' . 'If your peripheral circulation is bad, the organs do not receive a good blood supply. This may be a sign of a multiple organ failure ' she explained to our colleagues. “Queen Elizabeth II was still 96 years old, there is a normal aging of the body and it is already an extraordinary longevity” immediately reacts Dr. Emmanuelle Berthelot, cardiologist, contacted on September 8. Before recalling that “Cardiovascular disease is the leading cause of death among women. The queen died of a fairly banal cause of death, a cardiovascular problem ' .

What is peripheral vascular disease?

Peripheral vascular disease also called 'peripheral arterial disease' is a blood circulation disorder caused by fatty deposits ( atherosclerotic plaque ) on the walls of the arteries (atherosclerosis) which leads to narrowing of the arteries (stenosis) and obstructions in the vessels . 'The arteries are present throughout the body, When the atheroma plaques are deposited in the arteries of the heart, it makes a heart attack . When they are deposited at the peripheral level (outside the heart): this is called obliterating arteriopathy of the lower limbs or AOMI' continues Dr. Berthelot. PAD occurs more frequently at the level of the legs but can also touching other arteries that carry blood out of the heart (arteries that go to the aorta, brain, arms, kidneys and stomach). It is a disease that would affect 5% of people under 60 in France, 20% over 65-70 years old.

Do we die from it?

'In general, we do not die of this disease but of its complications, answers the cardiologist. Due, for example, to the lack of oxygenation of the tissues, the wounds do not heal, become infected and we die of the infection.

What are the symptoms of peripheral vascular disease?

Many people experience no symptoms at the onset of peripheral vascular disease. Some feel discomfort or pain in the lower legs when walking. “For many individuals, symptoms will not appear until the artery has narrowed by 60% or more” indicate the Canadian Foundation for Vascular Health . The most common signs include:

  • Fatigue
  • Pain in the legs, thighs, or buttocks when walking that goes away when you rest
  • Discomfort when walking (intermittent claudication)
  • Pain in feet or toes, at rest
  • Ulcers or sores on the skin of the feet or toes.

The symptoms felt in the legs are due to the difficulties of blood irrigation in this area.

How is it diagnosed?

The diagnostic test for peripheral vascular disease is the echo doppler lower limb arteries. He will specify the affected arteries, the degree of damage... Can also be performed: a ECG , a scintigraphy even a coronary angiography . The doctor will also look for possible high blood pressure by taking the patient's blood pressure. A blood test may be prescribed to look for an excess of cholesterol , diabetes, kidney failure, bleeding disorder, red blood cells or platelets.

What are the treatments ?

PAD is a serious disease that can go as far as amputation, it reduces life expectancy. It is very important to follow your treatment well. The treatment is multidisciplinary. It aims to correct cardiovascular risk factors through lifestyle and dietary rules, a walking rehabilitation program, medical and surgical treatments. the Surgical treatment is indicated depending on the degree of severity peripheral arterial disease. The surgeon can propose an endovascular treatment (percutaneous arterial dilation using a balloon and/or implantation of a metal endoprosthesis or stent ) or conventional surgical treatment (bypass, endarterectomy, etc.).

Thanks to Dr Emmanuelle Berthelot, cardiologist, hospital doctor and head of a clinical unit in the cardiology department of Bicêtre hospital, in the Paris region.

Doctor pinpoints the tell-tale sign at the Queen's final royal appointment that death was near: 'She was putting on a brave face', Dailymail, 9 septembre 2022

Obliterating arteriopathy, French Federation of Cardiology.

Screening for peripheral arterial disease, Cochrane, 2014