Peripheral Arterial Disease (P.A.D.)
Diagnosis
Your Family and Medical History
P.A.D. is diagnosed based on a person's medical and family histories, a physical exam, and results from medical tests. To learn about your medical and family histories, your doctor may ask about
- your risk factors for P.A.D.
- your symptoms, including those that occur when walking, exercising, sitting, standing, or climbing
- your diet
- any medicines you take
- family members with cardiovascular disease.
The Physical Exam
During the physical exam, your doctor will look for signs of P.A.D. He or she may check the blood flow in your legs or feet to see whether you have weak or absent pulses. Your doctor also may check the pulses in your leg arteries for an abnormal whooshing sound called a bruit (broo-EE). A bruit may be a warning sign of a narrowed or blocked section of artery.
During the physical exam, your doctor may compare blood pressure between your limbs to see whether the pressure is lower in the affected limb. He or she may also check for poor wound healing or any changes in your hair, skin, or nails that might be signs of P.A.D.
Diagnostic Tests
Tests are used to diagnose P.A.D. These tests include
- an ankle-brachial index (ABI). This test compares blood pressure in your ankle(s) to blood pressure in your arm(s). It shows how well blood is flowing in your limbs.
- a Doppler ultrasound. This test uses sound waves to show whether a blood vessel is blocked. A blood pressure cuff and special device measure blood flow in the veins and arteries of the limbs. A Doppler ultrasound can help find out how severe P.A.D. is.
- a treadmill test. This test shows if you have any problems during normal walking, how severe your symptoms are, and what level of exercise brings on your symptoms.
- a magnetic resonance angiogram (MRA). This test uses magnetic and radio waves to take pictures of blood vessels inside your body. An MRA can find the location of a blocked blood vessel and show how severe the blockage is.
- an arteriogram. This test is used to find the exact location of a blocked artery. Dye is injected through a needle or catheter (tube) into an artery, then an X-ray is taken. The pictures from the X-ray can show the location, type, and extent of the blockage in the artery.
- blood tests. These tests check for P.A.D. risk factors such as diabetes and high cholesterol levels.
