Peripheral Arterial Disease
Evaluation
General—type of peripheral vascular disease affecting blood vessels outside the heart and brain
Clinical
Claudication—if in the legs, then pain/fatigue with walking which is relieved by rest.
Limb examination—diminished pulses, hair loss, brittle nails, scaly and dry skin, pallor, ulcer/gangrene.
Mechanism—narrowing of blood vessels inhibits blood flow; usually occurs in legs
Epidemiology—12 million Americans with peripheral arterial disease (PAD)
Risk factors—smoking, diabetes, hypertension, hyperlipidemia, and hyperhomocystinemia, age older than 40 years
Diagnostic algorithm
Screen through ankle-brachial index (ABI), which is the ratio of resting systolic blood pressure at the ankle to resting systolic blood pressure at the arm, as determined by use of a blood pressure cuff and Doppler ultrasonography.
