A specialist with the Philippine Heart Association is warning that recurring leg pain could be an early sign of a vascular condition called limb ischemia and a precursor to a heart attack.

During the association’s “Usapang Puso sa Puso” webinar, Dr. Pablo Joel Nocom said limb ischemia, or LI, is not just a disease of the legs but can also be a sign of a person’s overall cardiovascular health. He noted a fatal link between limb pain and cardiovascular disease, explaining that when cholesterol clogs arteries in the legs, it often indicates a similar hardening of arteries in the heart and brain.

“The leg pain that comes with a cold sensation is telling you that you may be suffering from poor blood circulation that puts you at high risk of fatal cardiovascular complications,” he said.

Nocom said LI can be a serious condition that may lead to amputation, stroke, or death if left untreated.

He described two types of LI: acute LI, or ALI, which occurs when blood flow to a limb is suddenly cut off, and critical LI, or CLI, which develops over time in people with diabetes, hypertension, or existing heart disease. CLI is characterized by persistent pain, non-healing wounds, and gangrene.

The physician urged the public to be aware of symptoms such as persistent leg pain, especially at night or while resting, sudden severe pain in a limb, or coldness and paleness in the skin with numbness or weakness.

For ALI, Nocom said to look for the “6 Ps”: Pain, Pallor (pale skin), Pulselessness (weak or absent pulse), Paresthesia (tingling), Paralysis and Poikilothermia (coldness).

He noted that treatment for limb ischemia, which includes angioplasty and bypass surgery, is expensive and often limited to specialized hospitals in the Philippines. Access to vascular surgeons and interventional cardiologists is also scarce outside of Metro Manila.

“Because treatment is not always within reach, prevention and early detection are critical,” Nocom said.