How is peripheral arterial disease tested and diagnosed?
If you tell your physician about pain in the legs when you walk -- pain that comes on at a particular time and then goes away when you rest that really prevents you from walking on, pain that we would call claudication -- that simple fact and the history is often all we need to make a diagnosis of peripheral arterial disease or PAD. But to be certain it's there, the physician will examine the legs, will feel the pulses throughout the legs, will often listen with a stethoscope over the blood vessels to listen for noise that turbulent blood flow makes. Then we'll do what's called an ankle-brachial index test where the blood pressure is taken not just in the arm but also in the leg. The blood pressure is taken with a special device called a Doppler so that the blood pressure can be measured very carefully and we can compare the blood pressure in the arms and legs. We would expect that the blood pressure will be nearly equal or in fact greater in the legs. If there is lower blood flow in the legs, that indicates a significant problem with blood flow that is generally caused by atherosclerosis. Atherosclerosis tends to affect blood flow to the legs more than to the arms, so often falling blood flow is seen there first.
