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Peripheral artery disease most commonly affects the legs, but other arteries may also be involved, such as those of the arms, neck, or kidneys. [4] [17] Peripheral artery disease (PAD) is a form of peripheral vascular disease. Vascular refers to both the arteries and veins within the body. PAD differs from peripheral veinous disease. PAD means ...
Peripheral artery disease is typically diagnosed if the systolic blood pressure in the ankle divided by the systolic blood pressure in the arm is less than 0.9. In general, claudication is often seen in people with an ABI between 0.4 and 0.9, rest pain is seen between 0.2 and 0.4, and tissue loss, ulcers, and gangrene between 0 to 0.4.
Reviewing a patient's family history and conducting a physical examination are important steps in making a diagnosis. Physical exams may differ depending on the type of vascular disease suspected. For example, in the case of a peripheral vascular disease, a physical exam consists of checking blood flow in a patient's legs. [28] [29]
A peripheral vascular examination is a medical examination to discover signs of pathology in the peripheral vascular system. It is performed as part of a physical examination, or when a patient presents with leg pain suggestive of a cardiovascular pathology. The exam includes several parts: Position/lighting/draping; Inspection; Palpation ...
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
In an ischaemic leg, elevation to 15 degrees or 30 degrees for 30 to 60 seconds may cause pallor. (This part of the test checks for elevation pallor.) A vascular angle of less than 20 degrees indicates severe ischaemia. [1] [2] From a sitting position, in normal circulation, the foot will quickly return to a pink colour.
Intermittent claudication is a symptom and is by definition diagnosed by a patient reporting a history of leg pain with walking relieved by rest. However, as other conditions such as sciatica can mimic intermittent claudication, testing is often performed to confirm the diagnosis of peripheral artery disease. [citation needed]
The prognosis for patients with peripheral vascular disease due to atherosclerosis is poor; patients with intermittent claudication due to atherosclerosis are at increased risk of death from cardiovascular disease (e.g. heart attack), because the same disease that affects the legs is often present in the arteries of the heart. [8]