Peripheral arterial disease
Symptoms develop when the metabolic demand of tissues is greater than vessels are able to deliver. Most patients with PAD are asymptomatic. In those who develop symptoms, look for extremity pain with activity that is relieved with rest (claudication), limb ischemia with the development of ulcers or gangrenous lesions, or critical acute limb ischemia leading to pallor, pulselessness, paresthesia, and poikilothermia.
Atherosclerosis is a type of arteriosclerosis that can lead to narrowing of blood vessels. When atherosclerotic plaques involve 70%-80% of the luminal diameter, blood flow may become limited, particularly during times of physical exertion and increased demand. Plaque rupture may cause occlusion of coronary vessels or cerebrovascular vessels, leading to ischemia and infarction that present as myocardial infarctions and strokes, respectively.
I73.9 – Peripheral vascular disease, unspecified
399957001 – Peripheral arterial occlusive disease
Differential Diagnosis & Pitfalls
- Cervical or lumbar spinal stenosis
- Peripheral neuropathy
- Venous thrombosis
- Reflex sympathetic dystrophy
- Arterial dissection (see, eg, carotid artery dissection, aortic aneurysm dissection)
- Vasculitis (see thromboangiitis obliterans, Kawasaki disease, giant cell arteritis)
Drug Reaction Data