What You Should Know About Peripheral Artery Disease (PAD)

When atherosclerosis affects the legs or other extremities, it's called peripheral artery disease (PAD). Diagnosed early enough, it can be managed with medication and healthy lifestyle changes. Walking can be the best medicine for PAD.

By Sharonne Hayes, M.D., FACC
Illustrations by Lisa Clark, M.A., CMI

A patient of mine, Diane, told me that every time she walked more than two or three blocks, she'd get a cramp in her left calf. She'd wait a bit and walk another couple of blocks, but the cramp would come back.

Diane was describing a classic symptom of advanced peripheral artery disease (PAD), which is a form of atherosclerosis, or plaque buildup, inside the walls of arteries serving the arms, legs, kidneys, and abdominal organs. Her muscles were cramping because they weren't getting enough oxygen because of reduced blood flow.

What is PAD?
Blood flow to the extremities decreases because of plaque buildup in the arteries.

What are the symptoms of PAD?

• Leg pain. Fatigue, heaviness, tiredness, or cramping in the buttocks, thigh, or calf that occurs while walking or climbing stairs.
• Leg pain while resting. Advanced PAD may cause symptoms at rest or at night, with a continual burning or pain in the legs or feet. The pain often is worse when the legs are elevated and is relieved by dangling the legs over the side of a bed or chair.
• Poor nail or hair growth on arms or legs.
• Cold or bluish extremities. This can be detected by comparing the arm or leg with the opposite arm or leg.
• Nonhealing sores or wounds. This may signify severe PAD.
• Erectile dysfunction. Arteries to the penis are branches from arteries to the legs.

In its early stages, PAD may cause no symptoms because the blockages are not severe enough to reduce blood flow. Because most people with early PAD do not have symptoms, or perhaps attribute symptoms to aging or other causes, they may not be diagnosed until their symptoms are limiting.

The good news is that when PAD is diagnosed early, successful management strategies can prevent or even reverse progression of the disease.