Peripheral Arterial Disease
(Intermittent Claudication · PAD)
In this condition factsheet:
The Facts on Peripheral Arterial Disease
Peripheral arterial disease (PAD) is a condition involving clogging of the arteries around the body, most commonly in the legs. PAD occurs more frequently as people get older and often goes hand-in-hand with coronary artery disease (CAD). PAD does most of its damage before any symptoms are seen.
Causes of Peripheral Arterial Disease
PAD is caused by atherosclerosis (hardening of the arteries) or damaged arteries. If the arteries become narrowed or damaged, deposits of plaque, calcium, or cholesterol can settle in these areas and cause an obstruction.
Men, smokers, and seniors are more likely to develop PAD.
You also have a greater risk of developing PAD if you:
- have high blood pressure
- have high cholesterol or eat a high-fat diet
- are overweight or have a sedentary lifestyle
- are a smoker
- are older than 60
- have diabetes
- have a family history of atherosclerosis
- are postmenopausal
Symptoms and Complications of Peripheral Arterial Disease
Arteries carry oxygen-rich blood to the muscles. When an artery becomes narrower, it can't carry enough of the oxygen-rich blood to the muscle. This decrease in oxygen is called ischemia. A muscle that doesn't get enough oxygen feels painful, achy, cramped, and tired during physical activity. Skin that doesn't get enough nutrients can't heal quickly and can become infected easily.
Since most people who have PAD don't have any symptoms until the damage has begun, it's important to pay attention to possible signs or symptoms such as:
- leg pain when walking short distances, called intermittent claudication
- sores that are slow to heal on the leg or foot
- cold, pale, or bluish feet due to poor blood circulation
Symptoms of intermittent claudication are different depending on whether it's due to gradual or sudden narrowing of an artery. The first signs of a gradual narrowing include tiredness, aching, cramping, and pain in the calf, thigh, buttock, foot, or hip that starts during physical activity and eases with rest. The symptoms can be brought on by walking and are more noticeable when walking quickly or uphill. After a rest of up to 5 minutes, you can usually walk about as far as you did before resting. As the arterial narrowings get worse, the distance you can walk without remaining in pain gets shorter and shorter. At its worst, the pain comes on at rest and can keep you from sleeping.
Leg pain from PAD may keep you from exercising or walking around – the more it hurts, the less you will want to move. Since lack of exercise is one of the risk factors for PAD, this can make the situation worse.
If the blockage prevents blood from reaching the foot, the foot will become cold and numb. The skin on the foot may be dry and scaly, and the nails and hair won't grow properly. Sores might develop on the foot, especially on the toes or heel. When the blockage is quite severe, or the sores and infections on the feet are untreated, the foot tissue may die due to gangrene. Gangrene is a very serious condition where loss of blood supply leads to tissue death. It can lead to amputation. People with diabetes are especially at risk.
If a blood clot blocks an artery suddenly and completely, the leg quickly becomes painful, cold, numb, and blue in colour. There's usually no pulse felt below the blocked part of the artery. This is a medical emergency and you should seek immediate medical attention.
