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Peripheral artery disease - legs

  • Alternative Names

    Peripheral vascular disease; PVD; PAD; Arteriosclerosis obliterans; Blockage of leg arteries; Claudication; Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of the legs; Recurrent leg pain and cramping; Calf pain with exercise


    Symptoms

    The classic symptoms are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms usually appear during walking or exercise and go away after several minutes of rest.

    • At first, these symptoms may appear only when you walk uphill, walk faster, or walk for longer distances.
    • Slowly, these symptoms come on more quickly and with less exercise.

    Your legs or feet may feel numb when you are at rest. The legs also may feel cool to the touch, and the skin may appear pale.

    When peripheral artery disease becomes severe, you may have:

    • Impotence
    • Pain and cramps at night
    • Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful
    • Pain that is worse when the leg is elevated and improves when you dangle your legs over the side of the bed
    • Ulcers that do not heal

    Signs and tests

    During an examination, the health care provider may find:

    • A whooshing sound with the stethoscope over the artery (arterial bruits)
    • Decreased blood pressure in the affected limb
    • Loss of hair on the legs or feet
    • Weak or absent pulses in the limb

    When PAD is more severe, findings may include:

    • Calf muscles that shrink (wither)
    • Hair loss over the toes and feet
    • Painful, non-bleeding ulcers on the feet or toes (usually black) that are slow to heal
    • Paleness of the skin or blue color in the toes or foot (cyanosis)
    • Shiny, tight skin
    • Thick toenails

    Blood tests may show high cholesterol or diabetes.

    Tests for peripheral artery disease:

    • Angiography of the arteries in the legs (arteriography)
    • Blood pressure measured in the arms and legs for comparison (ankle/brachial index, or ABI)
    • Doppler ultrasound exam of an extremity
    • Magnetic resonance angiography or CT angiography