Peripheral Vascular Disease
When to Seek Medical Care
When you have symptoms of peripheral vascular disease in a leg or a foot (or in an arm or a hand), see your health care provider for an evaluation. Generally, peripheral vascular disease is not an emergency. On the other hand, it should not be ignored.
- Medical evaluation of your symptoms and effective treatment, if indicated, may prevent further damage to your heart and blood vessels.
- It may prevent more drastic events such as a heart attack or stroke or loss of toes and feet.
If you have symptoms of peripheral vascular disease along with any of the following, call 911 for emergency medical care:
- Pain in the chest, upper back, neck, jaw, or shoulder
- Fainting or loss of consciousness
- Sudden numbness, weakness, or paralysis of the face, arm, or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden dizziness, difficulty walking, loss of balance or coordination
- Sudden severe headache with no known cause
Do not try to "wait it out" at home. Do not try to drive yourself. Call 911 right away for emergency medical transport.
Exams and Tests
Tests your doctor may use to identify or rule out PVD include:
Edinburgh Claudication Questionnaire:This is a test used by many medical professionals to diagnose peripheral artery disease. It is a series of 6 questions and a pain diagram. It is accurate at diagnosing PAD in people with symptoms up to about 90% of the time.
Ankle/brachial index (ABI): This is one of the most widely used tests for a person who has symptoms suggesting intermittent claudication -- pain associated with PVD that comes and goes as a result of narrowed blood vessels.
- This test compares the blood pressure in the arm (brachial) with the blood pressure in the legs.
- In a person with healthy blood vessels, the pressure should be higher in the legs than in the arms.
- An ABI above 0.90 is normal; 0.71-0.90 indicates mild PVD; 0.41-0.70 indicates moderate disease; and less than 0.40 indicates severe PVD.
Treadmill exercise test: If necessary, the ABI will be followed by a treadmill exercise test.
- Blood pressures in your arms and legs will be taken before and after exercise (walking on a treadmill, usually until you have symptoms).
- A significant drop in leg blood pressures and ABIs after exercise suggests PVD.
- Alternative tests are available if you are unable to walk on a treadmill.
- If the leg pulse can't be felt, the use of a portable Doppler flow probe will quickly reveal the absence or presence of an arterial flow.
To help locate blockages in your blood vessels, any of several tests, such as angiography, ultrasonography, or MRI (magnetic resonance imaging), can be used.