If you have symptoms of peripheral artery disease (PAD), it’s important to talk with a health care provider. PAD symptoms can look like other problems, including nerve, muscle, joint or spine conditions. Getting the right diagnosis can help you start the right treatment.
PAD happens when narrowed or blocked arteries reduce blood flow, most often to the legs and feet. Finding PAD early can help improve blood flow, ease leg pain and lower the risk of serious problems. PAD can also raise your risk of heart attack and stroke, so diagnosis is an important step in protecting your overall heart and vascular health.
If you smoke, have diabetes, high blood pressure, high cholesterol, kidney disease or a history of heart or vascular disease, ask your doctor whether PAD screening is right for you.
PAD diagnosis usually starts with a medical history and physical exam. Your provider will ask about your symptoms, health history and risk factors. They may also examine your legs and feet for signs of reduced blood flow, such as:
Your provider may also recommend one or more tests to check blood flow and find narrowed or blocked arteries.
The ankle-brachial index, or ABI, is a simple test that compares blood pressure in your ankles with blood pressure in your arms. A lower blood pressure in the ankle may mean blood is not flowing well to the legs.
ABI is one of the most common first tests used to diagnose PAD. It is quick, noninvasive and usually done in a clinic or vascular lab. ABI is a key PAD test and that results may guide whether more testing is needed.
Some people have PAD symptoms even when their resting ABI is normal. In this case, your provider may recommend an exercise ABI or walking test.
During this test, you may walk on a treadmill or complete a timed walking test. Your blood pressure is checked before and after activity to see how exercise affects blood flow in your legs.
A Doppler ultrasound uses sound waves to measure how blood moves through your arteries. It can show the speed and direction of blood flow and help locate narrowed or blocked areas.
CT angiography, or CTA, uses X-rays and contrast dye to create detailed images of your blood vessels. It can help show where blockages are located and how severe they are.
Magnetic resonance angiography, or MRA, uses magnetic imaging to create pictures of your blood vessels. It may be used when your provider needs more detailed information about blood flow and artery structure.
Angiography uses contrast dye to show blood vessels on imaging. In some cases, this is done through a catheter placed into a blood vessel. Catheter angiography is often used when planning or performing a procedure to open a narrowed or blocked artery.
Blood tests do not diagnose PAD by themselves, but they can help identify conditions that raise your risk. Your provider may check:
Your provider may describe PAD based on your symptoms, test results and risk of complications. PAD may be grouped into these general categories:
Some people have PAD but do not notice symptoms. They may still have reduced blood flow or changes in how they walk.
Many people with PAD have leg pain, cramping, heaviness or fatigue when walking or exercising. Symptoms usually improve with rest.
More advanced PAD can cause pain in the foot or leg even when you are resting, especially at night or when lying down.
Severe PAD can lead to non-healing sores, ulcers, infection or tissue damage in the feet or toes. This needs prompt medical care.
Sudden severe leg pain, a cold or pale foot, numbness, weakness or loss of movement may be a medical emergency. Seek emergency care right away.
If you are diagnosed with PAD, your provider will talk with you about treatment options. Your plan may include lifestyle changes, medicine, a structured walking program, wound care or a procedure to improve blood flow.
The goal is to manage symptoms, protect your legs and feet and lower your risk of heart attack, stroke and other vascular complications.
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