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Peripheral arterial disease happens when plaque from cholesterol and calcium build up in the limbs and organs. This is called atherosclerosis and it can harden or narrow the arteries. It blocks the flow of blood through the arteries. PAD usually affects the legs but can affect the blood flow that supplies the arms, kidneys, head and stomach. Blocked flow to the extremities can cause pain and numbness to the legs and can increase the risk of infection in the legs. If it is severe, gangrene happens, which is tissue death and which may result in an amputation of a portion of the leg. The pain worsens when you walk a distance or climb stairs. The main risk factor for PAD is smoking but high cholesterol and age play a role as well.

Having peripheral arterial disease puts you at a greater risk of getting coronary artery disease, stroke, transient ischaemic attacks and heart attacks. The risk is six to seven times greater for those that have PAD when compared to those that do not have PAD. If you have some kind of heart disease, you have a 33 percent chance of also having blocked arteries to the leg. Peripheral arterial disease is a treatable condition, especially when treated early. PAD treatment will slow or stop the progression of the disease and will potentially save the leg.

The most common cause of peripheral arterial disease is atherosclerosis. The cause of atherosclerosis is not known. Risk factors include smoking, high fat and cholesterol in the bloodstream, diabetes, insulin resistance or high blood pressure. Plaque builds up and may crack so that the injured artery becomes clotted with blood. This causes acute blockage of the artery unless the blood clot breaks up.

Signs and symptoms of PAD include intermittent claudication, which is pain in the legs while walking a certain distance or climbing stairs. There can be cramping in the affected leg and pain in the buttocks, thighs, calves and feet. Symptoms get better after resting. Intermittent claudication happens because the activity increases the need for more blood to the legs, which can't happen with PAD. The muscles won't get enough blood and the legs will hurt. About ten percent of PAD patients have intermittent claudication.

Other symptoms of PAD include having sores or wounds on the legs, toes or feet that do not heal. Weak or absent pulses in the legs or feet can happen and the skin may be pale or bluish. The skin is often cold to the touch when compared to the rest of the body. Nails may not grow and there is often erectile dysfunction.

To identify PAD, doctors need to check the medical and family history of the affected patient. There is a familial connection to having PAD. Personal risk factors are important as well and your doctor needs to do a complete examination in order to define the presence of peripheral arterial disease.

A simple test for PAD is called the ankle brachial index or ABI. This measures the difference between the blood pressure of your arm and the blood pressure of your leg. The normal range is 0.9 to 1.3. If the ankle blood pressure is much less than the blood pressure of the brachial area, then there is a chance there is atherosclerosis and blockage of the arteries, lowering the blood pressure. This test can be done annually on those people with risk factors for the disease.

A Doppler ultrasound is a test that uses sound waves to tell if a blood vessel is blocked or not. An ultrasound device can be run over the artery to detect the width of the artery and the flow through the artery. A treadmill test can also be done by having you run on a treadmill and see when symptoms start to happen. An ABI test can be done before and after the treadmill test to see what happens to the blood flow after exercise.

An MRI can be done along with angiogram dye to see the outline of the arteries and whether or not there are plaques. If this is not possible, you can tell the blockage of the artery using an x-ray and an angiogram.

Treatment of PAD involves making lifestyle changes including stopping smoking, lowering blood sugar, and eating healthy low fat diet. Lose weight if you are obese. There are medications which can help lower cholesterol and blood sugar, and can thin the blood if necessary. Surgery can be done to break up the plaque and remove it from the blocked artery.

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