Peripheral Artery Disease: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate peripheral arterial disease (pAVD):

Pathognomonic (characteristic of disease) is intermittent claudication. The following symptoms occur:

  • Pain in the muscles (reproducible, rapidly improving after a few minutes at rest) [localizations: see below].
  • Numbness, fatigue in the muscles.
  • Muscle cramps

All these symptoms occur during exertion, that is, when walking, and disappear at rest, that is, when the affected person remains standing.

Symptoms in the further course:

  • Rest pain, possibly nocturnal rest pain (> stage III according to Fontaine).
  • Cold sensation in the affected limb
  • Numbness sensation in the affected extremity
  • Ulcerations (skin ulcers) (stage IV according to Fontaine).

These symptoms occur more at night when the affected person is lying down (when lying low, the pain improves, as this allows more blood to enter the leg). With upright posture, the discomfort decreases.

Associated symptoms as the condition progresses:

  • Hair loss in the affected area
  • Clearly thickened nails
  • Shiny skin
  • Decreased skin temperature
  • Paleness of the affected limb
  • Localized peripheral cyanosis – bluish discolored skin (at the affected site).

Localizations

  • Pelvic type: occlusion in the aorta or iliac artery (35% of pAVD types)
    • Femoral pulses: not palpable
    • Pain: buttocks and thighs
  • Thigh type: occlusion in the femoral artery (50%).
    • Popliteal pulses: not palpable; flow sounds over femoral artery.
    • Pain: calves; pale, cool feet.
  • Peripheral type: occlusions in the lower leg and foot arteries (15%).
    • Foot pulses: not palpable
    • Pain: sole of foot

Other notes

  • Approximately 75% of pAVK patients are asymptomatic (without symptoms)!
  • Claudication occurs only when about 75% of the vessel is occluded.
  • In intermittent claudication, men are more likely to report pain at rest, while women are more likely to report pain on movement.

The following symptoms and complaints may indicate acute arterial occlusion (6 P according to Pratt):

  1. Pain (pain)
  2. Pallor (pallor)
  3. Pulselessness (Pulselessness)
  4. Paresthesia (sensory disturbance)
  5. Paralysis (inability to move)
  6. Prostration (shock)

Etiology (causes)

  • Embolism: 70-80% (cardiac embolism 90% + arterio-arterial embolism 10%).
  • Arterial thrombosis 30-20 %.