11
Table 5. Patients at Increased Risk for PAD
Age ≥65 y
Age 50–64 y, with risk factors for atherosclerosis (eg, diabetes, history of smoking,
dyslipidemia, hypertension), chronic kidney disease, or family history of PAD
Age <50 y, with diabetes and 1 additional risk factor for atherosclerosis
Individuals with known atherosclerotic disease in another vascular bed (eg, coronary,
carotid, subclavian, renal, mesenteric artery stenosis, or AAA)
Modified with permission from Gerhard-Herman MD, et al. Copyright © 2017 American
Heart Association, Inc., and American College of Cardiolog y Foundation.
Table 6. History and Physical Examination Findings
Suggestive of PAD
History
• Claudication
▶ Pain type: Aching, burning, cramping, discomfort, or fatigue
▶ Location: Buttock, thigh, calf, or ankle
▶ Onset/offset: Distance, exercise, uphill, how long for relief after rest (typically <10
min for typical claudication)
• Other nonjoint-related exertional lower extremity symptoms (not typical of
claudication) or symptoms of impaired walking function
▶ Lower extremity muscular discomfort associated with walking that requires >10
min rest to resolve
▶ Leg weakness, numbness, or fatigue during walking without pain
• Ischemic rest pain
• History of nonhealing or slow-healing lower extremity wound
• Erectile dysfunction
Physical Examination
• Abnormal lower extremity pulse palpation (femoral, popliteal, dorsalis pedis, or
posterior tibial arteries)
• Vascular bruit (eg, epigastric, periumbilical, groin)
• Nonhealing lower extremity wound
• Lower extremity gangrene
• Other physical findings suggestive of ischemia (eg, asymmetric hair growth, nail bed
changes, calf muscle atrophy, or elevation pallor/dependent rubor)
Modified with permission from Gerhard-Herman MD, et al. Copyright © 2017 American
Heart Association, Inc., and American College of Cardiolog y Foundation.
