Symptoms
People with peripheral artery disease (PAD) may or may not have symptoms. Because of silent symptoms, many cases of PAD go undiagnosed.
Intermittent Claudication
Claudication comes from the Latin word "to limp." Claudication is crampy, leg pain that occurs during exercise, especially walking. The pain is due to insufficient blood flow in the legs (caused by blocked arteries). Intermittent means the pain comes and goes. Intermittent claudication is the most prominent symptom of PAD. About a third to a half of patients with PAD have this symptom.
The most frequently affected artery in intermittent claudication is the popliteal artery. This artery leads off from the femoral artery (the major artery in the thigh). It continues below the knee where it branches off and carries blood to the muscles in the calf and foot.
PAD-related leg pain is relieved only by rest. Leg pain occurs in one leg in 40% of patients and in both legs in 60% of patients.
There is also some evidence that people with PAD have blood cells that are prone to forming clots.
Advanced Peripheral Artery Disease (Ischemic Rest Pain)
In advanced cases, the arteries are so blocked that even rest does not help. Leg pain that continues when lying down is called ischemic rest pain. Ischemia is the medical term for insufficient blood flow to tissues.
People with ischemic rest pain are at risk for ulcers and gangrene. In severe cases, amputation may be required.
Symptoms of advanced PAD can include:
- Calf muscles that shrink (wither)
- Hair loss over the toes and feet
- Thick toenails
- Shiny, tight skin
- Painful non-bleeding ulcers on the toe (usually black)
In some cases, blood clots form in the arteries in the legs, producing abrupt symptoms.
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