Peripheral Artery Disease (PAD)

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Signs and Symptoms

Signs of peripheral artery disease include absent or weak pulse, decreased blood pressure, and arterial bruits (sounds heard using a stethoscope) in the affected limb. In many cases, the condition is asymptomatic (i.e., does not cause symptoms). Signs and symptoms of PAD usually affect only one limb or are more severe in one leg than the other.

Common symptoms of PAD include muscle pain, difficulty walking, and sores (ulcers) that do not heal normally. Other symptoms include numbness, tingling, and muscle cramps that often occur at rest, variations in skin temperature and color (e.g., feeling cold, pale or bluish coloring [called cyanosis]), and hair loss or poor nail growth in the affected limb. These symptoms result from inadequate blood flow (circulation).

Pain caused by PAD usually worsens with activity (e.g., walking) and improves with rest. It occurs when muscles do not receive an adequate supply of blood. This pain is called intermittent claudication. "Intermittent" means coming and going or ceasing from time to time, and the term "claudication" comes from a Latin word that means "to limp."

Intermittent claudication often leads to limping or other changes in walking manner (gait). In severe cases, peripheral artery disease causes pain that continues even during periods of inactivity.

Complications
Peripheral artery disease increases the risk for heart attack, stroke (brain attack), transient ischemic attack (TIA; "mini stroke"), and other serious complications. The risk for complications is higher in patients who have uncontrolled diabetes, high blood pressure, high cholesterol, or severe kidney disease.

PAD complications include the following:

• Blood clots
• Erectile dysfunction (impotence)
• Infection
• Open sores on the skin (ulcers) that do not heal
• Pulmonary embolism (blood clot that travels to the lungs)

When blood flow (circulation) is severely reduced, a condition called ischemia results. Ischemia increases the risk for infections that can lead to gangrene (tissue death and decay). Gangrene often requires amputation (surgical removal) of the affected limb.

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