Peripheral Arterial Disease

Peripheral artery disease (PAD) may not cause symptoms, or symptoms may be mild. PAD symptoms include:

• Leg pain when walking.
• Muscle pain or cramping in the arms or legs, often in the calf.
• Muscle pain in the arms or legs that begins with exercise and ends with rest.
• Painful cramping in one or both of the hips, thighs or calves after walking or climbing stairs or other activities.
• Pain when using the arms, such as aching and cramping when knitting or writing.
• Coldness in the lower leg or foot, especially when compared with the other side.
• Leg numbness or weakness.
• No pulse or a weak pulse in the legs or feet.

The muscle pain in peripheral artery disease may:

• Be mild to extreme.
• Wake you up from sleep.
• Make it hard to walk or exercise.
• Occur during rest or when lying down if the condition is severe.

Other symptoms of PAD may include:

• Shiny skin on the legs.
• Skin color changes on the legs.
• Slow-growing toenails.
• Sores on the toes, feet or legs that won’t heal.
• Hair loss or slower hair growth on the legs.
• Erectile dysfunction.

Make an appointment for a health checkup if you have leg or arm pain or other symptoms of peripheral artery disease.

Peripheral artery disease (PAD) is often caused by a buildup of fats, cholesterol and other substances in and on the artery walls, a condition called atherosclerosis. The buildup is called plaque. Plaque can cause arteries to narrow, blocking blood flow. In PAD, plaque collects in the arteries of the arms or legs.

Less common causes of PAD include:

• Swelling and irritation of blood vessels.
• Injury to the arms or legs.
• Changes in the muscles or ligaments.
• Radiation exposure.

Risk factors for peripheral artery disease (PAD) include:

• A family history of peripheral artery disease, heart disease or stroke.
• Diabetes.
• High blood pressure.
• High cholesterol.
• Increasing age, especially after 65, or after 50 if you have risk factors for atherosclerosis.
• Obesity.
• Smoking.

Complications of peripheral artery disease (PAD) caused by atherosclerosis include:

• Critical limb ischemia. In this condition, an injury or infection causes tissue to die. Symptoms include open sores on the limbs that don’t heal. Treatment may include amputation of the affected limb.
• Stroke and heart attack. Plaque buildup in the arteries also can affect the blood vessels in the heart and brain.

To diagnose peripheral artery disease (PAD), a healthcare professional examines you. You are usually asked questions about your symptoms and medical history.

If you have peripheral artery disease, the pulse in the affected area may be weak or missing.

Tests to diagnose peripheral artery disease (PAD) or check for conditions that cause it may include:

• Blood tests. Blood tests are done to check for things that increase the risk of PAD, such as high cholesterol and high blood sugar.
• Ankle-brachial index (ABI). This is a common test used to diagnose PAD. It compares the blood pressure in the ankle with the blood pressure in the arm. You may be asked to walk on a treadmill. Blood pressure readings may be taken before and right after exercising to check the arteries during walking.
• Ultrasound of the legs or feet. Sound waves create pictures of how blood moves through the blood vessels of the legs or feet. Doppler ultrasound is a special type of ultrasound used to spot blocked or narrowed arteries.
• Angiography. This test uses imaging tests and a dye to look for blockages in the arteries. The dye is given through a blood vessel. It helps the arteries show up more clearly on the test images.