What is peripheral arterial disease (PAD)?
Peripheral arterial disease (PAD) is narrowing or blockage of arteries that causes poor blood flow to your arms and legs. PAD is most common in the legs.
PAD is often caused by fatty buildup (plaque) in the arteries. Over time, plaque builds up in the walls of the arteries, including those that supply blood to your legs. This can limit blood flow to the muscles and other tissues of the legs. PAD can make it hard for you to walk. It can also lead to tissue death. Sometimes part of the leg must be removed by surgery (amputation).
If you have PAD, you're also likely to have plaque in other arteries in your body. This raises your risk of a heart attack and stroke.
Peripheral arterial disease is also called peripheral vascular disease.
What are the symptoms of peripheral arterial disease (PAD)?
Many people who have PAD don't have symptoms.
If you have symptoms, they may include a tight, aching, or squeezing pain in your calf, thigh, or buttock. This pain is called intermittent claudication. It usually happens after you have walked a certain distance. The pain usually goes away when you stop walking.
Other symptoms may include weak or tired legs. You might have trouble walking or balancing.
If PAD gets worse, you may have other symptoms caused by poor blood flow to your legs and feet. You may have cold, tingly, weak, or numb feet or toes, sores that are slow to heal, or leg or foot pain when you're at rest. The skin on your legs or feet might change color. It may be pale, bluish, or purplish. Your skin may look shiny or have blisters.
How is peripheral arterial disease (PAD) diagnosed?
Your doctor will talk with you about your symptoms and past health and do a physical exam. Your doctor will check your pulse at your groin, behind your knee, on the inner ankle, and on the top of your foot. An absent or weak pulse in these spots is a sign of PAD. The pulse in your wrist, forearm, or neck may also be checked.
Your doctor may check the skin on your leg and foot to look for signs of limited blood flow. These signs include blisters, shiny skin, and changes in skin color.
Tests you may have to confirm PAD include:
- Ankle-brachial index (ABI) test. This checks blood flow by comparing blood pressure in the ankles and the arms.
- Doppler ultrasound. This may be used to measure blood flow in the arteries.
- Magnetic resonance angiogram (MRA) or computerized tomography (CT) angiography. These might also be done before a procedure or surgery.
How is peripheral arterial disease (PAD) treated?
Treatment for PAD focuses on relieving symptoms, slowing the progress of the disease, and lowering your risk of heart attack and stroke.
Having a heart-healthy lifestyle can help you manage PAD. This lifestyle includes eating healthy foods, being active, staying at a weight that is healthy for you, getting enough sleep, and trying to quit or cut back on smoking or using other nicotine products.
If you have symptoms when you exercise, your doctor might recommend a specialized exercise program that may relieve symptoms. The goal is to be able to walk farther without pain.
You will likely take medicines to help lower your risk of heart attack and stroke. These include medicine to prevent blood clots, improve cholesterol, or lower blood pressure. You also may take a medicine that can help ease pain while you are walking.
People who have severe PAD may have bypass surgery or a procedure called angioplasty to improve blood flow to the legs.
How can you care for yourself when you have peripheral arterial disease (PAD)?
You can help manage PAD by having a heart-healthy lifestyle, managing other health problems, and trying to quit or cut back on smoking. Take medicine as prescribed. Take good care of your feet. Watch for new and worse symptoms, and know when to call your doctor.
Peripheral arterial disease (PAD): When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You have symptoms of a heart attack. These may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
- You have sudden symptoms in your leg or foot such as severe pain, numbness, weakness, tingling, cool skin, or skin color changes. Your skin may be pale, bluish, or purplish.
- You have symptoms of a stroke. These may include:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
- A sudden, severe headache that is different from past headaches.
Call your doctor now or seek immediate medical care if:
- You have leg pain that does not go away even if you rest.
- Your leg pain changes or gets worse. For example, if you have more pain with normal activity or the same pain with decreased activity, you should call.
- You have cold, tingly, weak, or numb feet or toes.
- You have leg or foot sores that are slow to heal.
- The skin on your legs or feet changes color. It may be pale, bluish, or purplish.
- The skin on your legs or feet has blisters or looks shiny.
- You have an open sore on your leg or foot that is infected. Signs of infection include:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the sore.
- Pus draining from the sore.
- A fever.
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
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