Arterial condition
Peripheral Artery Disease (PAD)
Narrowed arteries that limit blood flow to the legs and feet.
Overview
Peripheral artery disease, often shortened to PAD, happens when the arteries carrying oxygen-rich blood away from the heart become narrowed. The legs are the most common area affected. Many people notice discomfort while walking that eases with rest, though some people have no noticeable symptoms at all.
What is happening inside the body
Arteries deliver oxygen-rich blood from the heart to the muscles and tissues. Over time, fatty deposits called plaque can build up along the artery wall and reduce the space blood has to travel through. When a leg muscle asks for more oxygen during activity, a narrowed artery may not be able to supply it, and the muscle can cramp or ache.
Arterial circulation
Arteries carry blood away from the heart
Arteries deliver oxygen-rich blood from the heart out to the muscles and tissues. When an artery narrows, less blood reaches the tissue it supplies, which is why arterial symptoms often appear during walking or activity.
- Direction of flow: heart toward the body
- Common problem: narrowing that limits blood supply
- Typical pattern: cramping with activity, eased by rest
Circulation
Seeing the difference between arteries and veins.
Many leg symptoms become easier to understand once you know which direction the blood is traveling. Our side by side comparison explains both systems and how their problems differ.
Compare arterial and venous circulationCommon symptoms
- Cramping, aching, or tiredness in the calf, thigh, or hip while walking
- Discomfort that eases within a few minutes of resting
- Coldness in one foot or leg compared with the other
- Numbness, tingling, or weakness in the leg or foot
- Sores or wounds on the feet or toes that are slow to heal
- Changes in skin color, shiny skin, or slower nail and hair growth on the legs
Risk factors
- Smoking or a history of smoking
- Diabetes
- High blood pressure
- High cholesterol
- Older age
- A personal or family history of heart or vascular disease
- Kidney disease
When to be seen
When to see a cardiovascular specialist.
- Leg pain or cramping that returns each time you walk a similar distance
- A foot or toe wound that is not healing as expected
- Coldness, color change, or persistent numbness in one leg or foot
- Leg pain that is present at rest or wakes you at night
If you have severe chest pain, sudden severe shortness of breath, fainting, or signs of a stroke, call 911 or go to the nearest emergency room.
Evaluation
How the condition is evaluated.
- Conversation and physical exam
- Your physician reviews your symptoms, medical history, and risk factors, then examines your legs, feet, and pulses.
- Ankle-brachial index
- A simple, painless comparison of blood pressure at the ankle and the arm.
- Arterial duplex ultrasound
- Sound wave imaging that shows how blood is moving through the arteries of the leg.
- Advanced imaging when appropriate
- Additional imaging may be recommended if more detail is needed before planning treatment.
Treatment
Potential treatment options.
- Risk factor management
- Care focused on blood pressure, cholesterol, diabetes, and tobacco use, coordinated with your other physicians.
- Supervised activity guidance
- Walking programs are often part of a care plan and are tailored to what is appropriate for you.
- Medication
- Your physician may discuss medications that support circulation and overall cardiovascular health.
- Minimally invasive procedures
- When appropriate, procedures such as angioplasty or stent placement may be discussed to improve blood flow.
- Wound care coordination
- For slow-healing wounds, care is coordinated so circulation and healing are addressed together.
Treatment is individualized. What is appropriate for you depends on your evaluation, your symptoms, and your overall health, and it is decided together with your physician.
At our clinicView all services
Related Austin Cardiovascular Clinic services.
Cardiac Ultrasound
In-office echocardiography and vascular ultrasound imaging.
Angioplasty & Stents
Restoring blood flow through coronary and peripheral vessels.
Peripheral Vascular Disease
Full evaluation and treatment for arterial and venous disease.
Chronic Wound Care
Multidisciplinary care to promote healing of complex wounds.
Your care team
Physicians who care for this condition.
Questions & answers
Peripheral Artery Disease questions patients ask.
General education only. Your own answers depend on your evaluation.
It is a circulation condition in which arteries that carry blood away from the heart become narrowed, most often in the legs. Less blood reaches the muscles and tissues, which can cause discomfort during activity and, in some cases, slow wound healing.
People often describe a cramping, tight, or tired feeling in the calf, thigh, or hip. It usually appears during walking or climbing stairs and settles after a few minutes of rest. Not everyone with PAD feels pain, which is one reason an evaluation matters.
Walking increases the amount of oxygen your leg muscles need. If an artery is narrowed, it may not be able to deliver that extra blood flow, and the muscle can ache or cramp. Leg pain with walking can also have other causes, so it should be evaluated by a clinician.
Yes. Symptoms can be noticeable in one leg and mild or absent in the other, because narrowing does not always develop evenly on both sides.
PAD is a circulation condition that deserves medical attention. It can affect walking comfort and wound healing, and it may be a sign of arterial disease elsewhere in the body. A cardiovascular evaluation helps clarify what is happening and what care is appropriate for you.
Evaluation usually starts with your symptoms, medical history, and a physical exam. Noninvasive testing such as an ankle-brachial index or arterial duplex ultrasound is commonly used, and additional imaging may be recommended in some situations.
Many care plans begin with risk factor management, activity guidance, and medication. Whether a procedure is appropriate depends on your symptoms, your imaging, and your overall health, and that decision is made together with your physician.
Consider an evaluation if leg pain returns predictably with walking, if a foot wound is slow to heal, or if you notice coldness, color change, or numbness in one leg. Leg pain at rest or at night should be discussed promptly.