How Is Peripheral Artery Disease Diagnosed?

Many diseases have specific presentations that can serve as indicators for medical providers to test for their presence. In the case of some diseases, however, the symptoms can be attributed by providers to any number of unrelated conditions and, therefore, overlooked. One disease whose symptoms are often mistaken for those of less-serious conditions is Peripheral Artery Disease (PAD).

PAD most commonly occurs in the following two patient populations:

  • Individuals over the age of 70;
  • Individuals over the age of 50 with a medical history of diabetes or smoking, or;

While PAD can present in individuals under the age of 50 with a medical history of diabetes, smoking, obesity, high cholesterol and/or high blood pressure, such an occurrence is relatively rare in comparison to the aforementioned populations.

The root cause of PAD is untreated atherosclerosis, a hardening of the artery walls due to plaque buildup. It is commonly believed that atherosclerosis directly manifests in the form of Coronary Artery Disease (CAD); while this may be case in some instances, in many others, the symptoms of unchecked atherosclerosis first present as symptoms of PAD.

Symptoms of PAD include claudication (hip, thigh or calf pain after walking or climbing stairs), numbness, weakness, or a cold feeling in the legs and feet, open sores on legs, feet and toes that don’t heal, and ischemic rest pain (pain that occurs even in the absence of physical activity). Patients in at-risk populations who experience one or more of these symptoms are advised to schedule an appointment with their primary care physician for screening.

Because the symptoms of PAD often match those of the various comorbid conditions which put individuals at risk of PAD, the symptoms can often be mistaken as side effects of diabetes or simple aging. As a result, additional, more specific testing is typically required to properly ascertain whether or not the symptoms are attributable to PAD.

The QuantaFlo™ system from Semler Scientific is now used widely as a fast, reliable test to aid in the diagnosis of PAD.

Historically, the most common test for PAD is pulse and blood pressure checks in various areas of the body. Providers who find a weak or absent pulse in the lower extremities will often confirm the diagnosis with an ankle-brachial index (ABI), which compares the blood pressure in the patient’s ankle to the blood pressure in the patient’s arm.

In instances where the ABI does not definitively confirm PAD, providers may also request additional testing, such as ultrasound, angiography or catheter angiography. Some providers will also perform blood tests to evaluate an individual’s cholesterol and triglyceride levels and check for diabetes — this information can be invaluable in confirming whether or not a patient possesses any of the comorbid conditions often associated with PAD.