Pathophisiology and Clinical Presentation

Your peripheral arteries are channels of smooth muscle tissue that escort oxygen-rich blood to the distal areas of your body, and that blood is propelled forward by the pump of your body, the heart. In normal physiology, blood flows unimpeded to your limbs and provides the tissue there with nutrients and oxygen, where they are used to help repair the cells and promote proper functioning (McCance & Huether, 2019).

When developing Peripheral Artery Disease, your arteries can sometimes go through the process of atherosclerosis, or hardening of the arteries, when plaque builds up within an artery’s inner lining. This build up, along with a decrease in blood flow to your limbs, is diagnosed as Peripheral Artery Disease or PAD. It is most common to have PAD in your legs (McCance & Huether, 2019).

 

Image result for normal peripheral artery anatomy

Normal Artery and Artery With Plaque Buildup (2019)

When atherosclerosis, or hardening of the arteries, begins to affect your peripheral arteries, you may experience symptoms such as pain with walking or exercise and diminished pulses in your extremities.  This occurs when blood is unable to pass these blockages, and presents as pain during exercise as a result of the lack of oxygen-rich blood flow (McCance & Huether, 2019).

The most common test to diagnose PAD is an Ankle-Brachial Index or ABI, which is a quick and easy way to determine if you have PAD. An ABI compares two measures of your blood pressure, one at your upper arm and one at your ankle, to determine the difference of blood flow (McCance & Huether, 2019). Your doctor may recommend an ABI if you experience leg pain while walking or have diminished pulses in one or more extremities. Your doctor will discuss the results with you and recommend further treatment to prevent your condition from progressing.

 

 The illustration shows the ankle-brachial index test. The test compares blood pressure in the ankle to blood pressure in the arm. As the blood pressure cuff deflates, the blood pressure in the arteries is recorded.

Ankle-Brachial Index (2019)