Peripheral Artery Disease Pad Diagnosis

One of the first steps in the diagnosis of PAD is determining your relative risk. Your health provider will ask you questions to evaluate your medical history and relative risk. Information you’ll need to provide includes:

  • A description of your diet and lifestyle
  • Any medications you take (prescription, non-prescription and herbal)
  • Any PAD risk factors that apply to you
  • Family history information regarding cardiovascular disease or diabetes
  • Possible PAD symptoms.

Physical Exams for PAD Diagnosis

During the physical examination the doctor looks for possible PAD symptoms such as poor wound healing. A weak or undetectable pulse in the affected area suggests peripheral artery disease, as does decreased blood pressure in the limb.

During diagnosis of PAD the doctor may hear bruits when listening to blood flow with a stethoscope. Bruits are “whooshing” noises in the arteries that suggest blockages or narrowed arteries.

Blood tests will be ordered to measure cholesterol and triglyceride levels. Blood tests also rule out the possibility of diabetes, which can mimic PAD symptoms.

Diagnostic Tests for Peripheral Artery Disease

Diagnosis of PAD can include a number of different tests. Some tests are simply to confirm a PAD diagnosis. Other, more intensive tests identify the location of arterial blockages.

Blood Pressure and Ankle-Brachial Index Tests

You may undergo several blood pressure tests during a PAD diagnosis. The doctor may compare blood pressure in the affected limb with the unaffected limb: Blood pressure readings in a limb affected by PAD will be lower.

An ankle-brachial index, or ABI, compares blood pressure readings from the ankle and the arm. You may be asked to exercise on a tread mill during the ABI test so your blood pressure can be measured before and after exertion.

ABI test results determine if blockages impair a limb’s blood flow. While test results can be used for PAD diagnosis, they cannot identify the location of the blockage.

Doppler Ultrasound

A Doppler ultrasound allows doctors to see how well blood flows through the arteries. A Doppler ultrasound can also identify the location of narrowed or blocked arteries.

Arteriogram

An arteriogram, or angiogram, is a special X-ray used in the diagnosis of PAD. During the arteriogram, special dye is injected into the bloodstream that allows X-rays to capture images of the arteries. The resulting images can show the exact location of PAD blockages. Arteriogram dye may be injected or delivered through a thin catheter inserted into a groin artery.

Magnetic resonance or computerized tomography angiographies are more sophisticated versions of angiograms that allow doctors to evaluate blood flow in real time.

Resources

Mayo Clinic Staff. (2010). Peripheral artery disease (PAD). Retrieved March 6, 2011, from http://www.mayoclinic.com/print/peripheral-arterial-disease/DS00537/METHOD=print&DSECTION=all

National Heart Lung and Blood Institute. (2008). What is peripheral arterial disease? Retrieved March 6, 2011, from http://www.nhlbi.nih.gov/health/dci/Diseases/pad/pad_what.html

Society for Vascular Surgery. (2010). Peripheral artery disease (PAD). Retrieved March 6, 2011, from https://www.vascularweb.org/vascularhealth/Pages/peripheral-artery-disease-%28-pad-%29-.aspx