Peripheral artery disease, or PAD, diagnosis begins with a medical history and physical examination. Your health care professional also will ask about your symptoms and check the pulses in your legs.
Your physical exam may include:
- Ankle-brachial index, or ABI: This painless exam compares the blood pressure in your lower legs to the blood pressure in your arms. It takes only a few minutes and can be performed by your health care professional as part of a routine exam. A normal ABI is 1.00 or greater. A value less than or equal to 0.90 is considered abnormal, and, in severe disease, it’s less than 0.4. If your ABI results are normal or borderline (.91 to .99), an exercise treadmill ABI and/or a toe-brachial index test also may be done. See a detailed illustration of the ABI test.
If your ABI is abnormal, you may need more testing. Your health care professional may recommend one of these tests:
- Duplex ultrasonography: The non-invasive test visualizes the arteries and veins with sound waves and measures blood flow to indicate the presence of a blockage.
- Computed tomographic (CT) angiography: The non-invasive test uses X-ray and contrast agent (dye) to create pictures of blood vessels in the arteries in your abdomen, pelvis and legs. This test is particularly useful in people with pacemakers or stents.
- Magnetic resonance angiography (MRA): The test provides cross-sectional images like a CT without using X-rays.
- Angiography: During an angiogram, also called an arteriogram, a contrast dye is injected into the artery and X-rays are taken to show blood flow in the leg arteries to locate any blockages. Learn more about peripheral angiograms.
Remember, PAD often goes undiagnosed. Untreated it can lead to painful symptoms or loss of a leg. People with PAD also have an increased risk of coronary artery disease, stroke and heart attack. This is why the American Heart Association encourages people at risk to discuss PAD with their health care professional to ensure early diagnosis and treatment.