What is P.A.D.?

Most often described as poor circulation in the legs, P.A.D. is a serious condition that more than doubles your risk of heart attack or stroke. P.A.D. results when plaque build up causes narrowing in the arteries of the legs or those leading to the heart or brain and restricts the flow of oxygen-rich blood to these areas of the body. This may lead to blockages caused by clots formed if the plaque ruptures leading to a heart attack or stroke.

What are the symptoms of P.A.D.?

Symptoms of P.A.D. include the following conditions:

  • Painful cramping in one or both of your hips, thighs or calf muscles after certain activities, such as walking or climbing stairs (claudication)
  • Leg numbness or weakness
  • Coldness in your lower leg or foot, especially when compared with the other side
  • Sores on your toes, feet or legs that won’t heal
  • A change in the color of your legs
  • Hair loss or slower hair growth on your feet and legs
  • Slower growth of your toenails
  • Shiny skin on your legs
  • No pulse or a weak pulse in your legs or feet
  • Erectile dysfunction in men

What are the risk factors for P.A.D.?

If you’re over 50 and have one or more of the following conditions, you should get tested for P.A.D.

  • Smoking
  • Diabetes
  • Obesity (a body mass index over 30)
  • High blood pressure
  • High cholesterol
  • Increasing age, especially after reaching 50 years of age
  • A family history of peripheral artery disease, heart disease or stroke
  • High levels of homocysteine, a protein component that helps build and maintain tissue

But speak to your doctor, too, as you may have additional risk factors not listed here.

What is the testing procedure for P.A.D.?

Doctors diagnose P.A.D. with a physical exam or specific tests for the condition. One P.A.D. test that is often used is called an Ankle-Brachial Index (ABI) test. The 10-minute test is based on comparing the blood-pressure readings from your arms and ankles, which are then used to calculate your ABI number. An ABI number below 0.9 may mean you have P.A.D. This test is recommended in particular for people over 50 who have diabetes.

Other tests may include:

  • Doppler and Ultrasound (Duplex) imaging: a non-invasive method that visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of a blockage.
  • Computed Tomographic Angiography (CT): a non-invasive test that can show the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.
  • Magnetic Resonance Angiography (MRA): a non-invasive test that gives information similar to that of a CT without using X-rays.
  • Angiography: During an angiogram, also called an arteriogram, a contrast agent is injected into the artery and X-rays are taken to show blood flow, arteries in the legs and to pinpoint any blockages that may be present.

What are the treatment options for P.A.D.?

The following treatment options are recommended as effective ways to treat the condition:

  • Exercise therapy
  • Lifestyle modification
  • Medication
  • Diet
  • Quit smoking
  • Diabetes management
  • Blood pressure management
  • Foot care
  • Endovascular therapy
  • Vascular surgery
  • Speak to your doctor about which treatment option or combination of treatment options might work best for you.

Last Reviewed: February 25, 2019