Peripheral Artery Disease (PAD): Early Symptoms and Causes

Peripheral Artery Disease (PAD) is a progressive circulatory condition that affects the arteries supplying blood to the limbs, most commonly the legs. The condition often goes unnoticed in its early stages, leading to delayed diagnosis and an increased risk of serious complications, including non-healing ulcers, infections, and even limb loss. It is, therefore, important to recognise the initial warning signs and understand the underlying causes. To help, in this article, we will discuss Peripheral Artery Disease (PAD) in detail, including its causes, symptoms, diagnosis, and treatment options. Without further ado, let’s start by understanding the basics.

What is Peripheral Artery Disease (PAD)?

Peripheral Artery Disease (PAD) is a circulatory disorder in which the arteries supplying blood to the limbs, most commonly the legs, become narrowed or blocked due to a build-up of fatty deposits known as plaque. This process, called atherosclerosis, limits oxygen-rich blood flow to the muscles, especially during any physical movement or exercise.

Over time, reduced blood flow can cause discomfort, slow wound healing, and, in advanced cases, serious complications such as tissue death or gangrene. PAD is closely linked to cardiovascular diseases, as the same underlying process that narrows leg arteries can also affect the heart and brain. Therefore, recognising PAD early is essential for preventing broader vascular complications and maintaining healthy circulation.

Stages and Types of Peripheral Artery Disease

Peripheral Artery Disease (PAD) progresses gradually, and its severity depends on how much the arteries have narrowed and how well blood can circulate to the limbs. Recognising the stages helps in determining the most appropriate treatment approach and preventing complications. Stages and types of PAD include:

Asymptomatic PAD

In this early stage, there are no visible symptoms, but diagnostic tests such as the Ankle-Brachial Index (ABI) may detect reduced blood flow. Despite the absence of pain, the risk of cardiovascular events like heart attack or stroke remains higher.

Intermittent Claudication

This is the most common and moderate stage of PAD. Symptoms include:

• Pain, cramping, or fatigue in the calves, thighs, or hips during walking or exercise.
• Relief from discomfort after resting.
• Gradual decrease in walking distance due to recurring pain.

Critical Limb Ischaemia (CLI) 

A severe and advanced stage of PAD where blood flow is critically reduced. Common signs include:

• Persistent pain or burning sensation in the feet, even at rest.
• Non-healing wounds, ulcers, or dark patches on the toes or feet.
• Increased risk of tissue death (gangrene), sometimes requiring surgical treatment.

By understanding these stages, individuals can identify PAD early and seek timely vascular evaluation to prevent any irreversible damage.

How PAD Affects Blood Circulation and Limb Health?

Peripheral Artery Disease interferes with the smooth flow of oxygenated blood to the lower limbs, which can affect both muscle function and tissue health. The reduced circulation gradually impacts mobility, comfort, and healing.

Key ways PAD affects blood flow and limb health include:

• Reduced Oxygen Supply to Muscles: Causes pain or cramping during physical activity, known as intermittent claudication.
• Delayed Wound Healing: Cuts, blisters, or injuries take longer to recover due to poor circulation.
• Cold or Numb Feet: Insufficient blood flow leads to temperature changes and tingling sensations in the legs or feet.
• Weak Pulse in the Legs or Feet: Indicates narrowed or blocked arteries.
• Tissue Damage and Gangrene: In severe cases, prolonged lack of oxygen can cause tissue death, leading to ulcers or potential limb loss.

PAD not only compromises limb health but also serves as a warning sign for underlying cardiovascular problems, making timely diagnosis and management essential.

Symptoms and Warning Signs of Peripheral Artery Disease

Peripheral Artery Disease (PAD) develops gradually, and symptoms may vary from mild discomfort to severe pain depending on the stage of the disease. Recognising these warning signs early can help prevent complications and preserve limb function.

Early Symptoms of PAD

In the initial stages, symptoms often appear during physical activity and improve with rest. Common early signs include:

• Leg pain or cramping during walking or climbing stairs (intermittent claudication).
• Numbness, weakness, or fatigue in the legs or feet.
• Coldness in one leg compared to the other.
• Pale or bluish skin colour on the legs or feet.
• Slow-growing toenails or hair loss on the legs.

Advanced or Severe PAD Symptoms

As the disease progresses, pain and discomfort may persist even at rest. Signs of advanced PAD include:

• Continuous or worsening leg or foot pain.
• Non-healing wounds, ulcers, or sores on the feet or toes.
• Darkened or shiny skin on the legs or feet.
• Weak or absent pulse in the legs.
• Gangrene or tissue death in severe cases.

How to Identify PAD Pain from Normal Leg Cramps?

PAD-related pain is different from ordinary muscle cramps.

• It usually occurs during movement and eases after rest.
• Pain commonly affects the calves, thighs, or buttocks rather than general muscle areas.
• Cramping may worsen at night or when lying down.

Recognising these patterns can help distinguish PAD from routine muscle fatigue, prompting timely medical evaluation.

Causes and Risk Factors of Peripheral Artery Disease

Peripheral Artery Disease (PAD) develops mainly due to narrowing or hardening of the arteries, which reduces blood flow to the limbs. In some cases, inflammation, injury, or damage to blood vessels may also contribute to reduced circulation.

Common Causes of Peripheral Artery Disease

• Atherosclerosis: The main cause, where plaque made of fat, cholesterol, and calcium builds up in the artery walls.
• Inflammation of blood vessels: Chronic inflammation can damage arteries, making them more prone to narrowing.
• Injury or trauma: Physical damage to arteries from accidents or surgeries may lead to scarring and reduced blood flow.
• Radiation exposure: In some individuals who have undergone radiation therapy for cancer, nearby arteries may become hardened or narrowed over time due to treatment-related effects.

Major Risk Factors of PAD

Certain lifestyle and health factors increase the likelihood of developing PAD. Major risk factors are:

• Smoking: The leading modifiable risk factor; it damages blood vessels and reduces oxygen delivery.
• Diabetes: High blood sugar levels accelerate atherosclerosis and impair circulation.
• High cholesterol: Promotes fatty deposits inside arteries.
• High blood pressure (Hypertension): Weakens artery walls over time.
• Obesity and physical inactivity: Contribute to poor blood flow and increased cardiovascular strain.
• Age (over 50 years): Risk increases with advancing age.
• Family history of vascular or heart disease: Inherited factors can predispose individuals to PAD.

How is Peripheral Artery Disease Diagnosed?

Accurate diagnosis of Peripheral Artery Disease (PAD) is essential for assessing the severity of arterial blockages and planning suitable treatment. At Artemis Hospitals, advanced diagnostic facilities enable precise evaluation of blood flow and vascular health. Diagnosis for PAD involves:

Physical Examination and Medical History

The doctor examines the legs for weak pulses, pale skin, poor wound healing, or other visible signs of poor circulation. A detailed medical history is also taken to assess risk factors such as smoking, diabetes, and high cholesterol.

Ankle–Brachial Index (ABI) Test

In this test, the doctor measures blood pressure at the ankle and compares it with that in the arm to evaluate blood flow. A lower reading in the ankle suggests restricted circulation, which may indicate Peripheral Artery Disease (PAD). The procedure is quick, painless, and helps detect early signs of reduced blood supply to the limbs.

Imaging Tests: Doppler Ultrasound, Angiography, and CT Scan

To confirm diagnosis and identify the exact location and extent of arterial blockages, doctors may recommend:

• Doppler Ultrasound: Measures blood flow and detects narrowed or blocked arteries.
• CT or MR Angiography: Produces detailed images of the arteries using contrast dye.
• Conventional Angiography: A minimally invasive procedure using catheters and contrast agents to visualise arterial structure in real time.

Treatment Options for Peripheral Artery Disease

Treatment for Peripheral Artery Disease (PAD) focuses on improving blood circulation, reducing symptoms, and preventing further arterial damage. The choice of therapy depends on the severity of the blockage, overall health condition, and underlying risk factors. Common treatment options include:

Lifestyle Modifications and Exercise Therapy

• Smoking cessation: The most crucial step in slowing disease progression.
• Regular physical activity: Supervised walking or exercise programmes help improve circulation and walking distance.
• Healthy diet: Reducing saturated fats and including heart-healthy foods aids cholesterol control.
• Weight management: Maintaining a healthy body weight lowers stress on the cardiovascular system.

Medications for Blood Flow and Cholesterol Control

Doctors may prescribe:

• Antiplatelet agents (such as aspirin or clopidogrel) to prevent clot formation.
• Cholesterol-lowering drugs (statins) to reduce plaque buildup.
• Medications for blood pressure and blood sugar control to manage underlying risk factors.
• Cilostazol or pentoxifylline to improve walking ability and blood flow in the legs.

Angioplasty and Stenting Procedures

If required, minimally invasive procedures are performed that help open blocked arteries and restore normal circulation. Procedures such as:

• Angioplasty: A small balloon is inflated inside the artery to widen it.
• Stent placement: A thin wire mesh tube is inserted to keep the artery open after angioplasty.

Surgical Bypass Options for Severe PAD

In advanced or complex cases, bypass surgery may be performed to create a new path for blood flow around the blocked artery using a healthy vein or synthetic graft. This option helps relieve pain, promote wound healing, and prevent limb loss.

Complications of Untreated Peripheral Artery Disease

When Peripheral Artery Disease (PAD) is left untreated, restricted blood flow can cause long-term complications that affect mobility, tissue health, and cardiovascular function. These complications may become serious and require surgical or emergency intervention.

Common complications include:

• Chronic leg pain and reduced mobility: Persistent discomfort limits daily activities and physical endurance.
• Non-healing wounds and ulcers: Poor circulation slows the healing process, increasing infection risk.
• Tissue damage and gangrene: Severe oxygen deprivation can lead to tissue death, sometimes necessitating amputation.
• Increased risk of heart attack or stroke: PAD often coexists with coronary artery disease, raising the likelihood of cardiovascular emergencies.

When to Seek Medical Help?

Prompt medical attention can prevent Peripheral Artery Disease (PAD) from advancing to severe or irreversible stages. Individuals experiencing any of the following warning signs should consult a vascular specialist or cardiologist for evaluation. Seek medical help when you experience:

• Persistent leg pain or cramping, especially during walking or physical activity.
• Coldness or numbness in one or both feet.
• Slow-healing wounds or ulcers on the legs or feet.
• Skin discolouration, such as pale, bluish, or darkened areas on the legs.
• Weak or absent pulse in the lower limbs.
• Pain at rest or while lying down, which may indicate advanced disease.

If symptoms persist or worsen, seeking expert care is vital to prevent complications such as gangrene or tissue loss. Early intervention helps restore circulation and maintain overall vascular health.

Peripheral Artery Disease Care at Artemis Hospitals

At Artemis Hospitals, comprehensive care for Peripheral Artery Disease (PAD) combines advanced diagnostic technology, expert vascular specialists, and evidence-based treatment protocols to ensure the best possible outcomes for patients.

Advanced Vascular Diagnostic Facilities

Artemis Hospitals is equipped with state-of-the-art tools such as Doppler Ultrasound, CT Angiography, and Ankle-Brachial Index (ABI) testing to accurately assess arterial health and blood flow. These facilities help detect PAD in its earliest stages and guide targeted treatment plans.

Experienced Cardiologists and Vascular Surgeons

A multidisciplinary team of cardiologists, vascular surgeons, and interventional radiologists works together to manage all stages of PAD - from lifestyle guidance and medication management to minimally invasive angioplasty and complex bypass procedures. Their expertise ensures precision, safety, and faster recovery.

Comprehensive Treatment and Follow-up Care

Beyond immediate treatment, Artemis focuses on long-term vascular health. Patients receive continuous follow-up care, including lifestyle counselling, physiotherapy support, and cardiac rehabilitation when necessary. This holistic approach promotes recovery and helps prevent disease recurrence.

Book an Appointment Today

Early diagnosis and timely treatment can significantly reduce the risk of serious PAD complications such as ulcers, tissue loss, or amputation. At Artemis Hospitals, expert specialists use advanced diagnostic technology and evidence-based treatment to provide comprehensive vascular care. If you are looking for specialised evaluation or treatment for Peripheral Artery Disease, our team ensures precise diagnosis, personalised management, and continuous follow-up for long-term vascular health.

To book an appointment with a vascular specialist at Artemis Hospitals, call +91-124-451-1111 or WhatsApp +91 9800400498. Appointments can also be scheduled through the online patient portal or via the Artemis Personal Health Record mobile app, which is available on both iOS and Android devices.

Frequently Asked Questions (FAQs)

How do I know if leg pain is due to Peripheral Artery Disease (PAD)?

Leg pain from PAD often occurs during walking or physical activity and eases after rest. This symptom, known as intermittent claudication, usually affects the calves, thighs, or hips. If pain persists or worsens, it is important to consult a vascular specialist for evaluation.

What are the early symptoms of Peripheral Artery Disease?

Early signs include pain or cramping in the legs during activity, numbness, cold feet, and slow-healing wounds. Some individuals may not experience noticeable symptoms until the disease progresses.

Can Peripheral Artery Disease be cured permanently?

While PAD cannot be completely cured, it can be effectively managed through a combination of lifestyle changes, medications, and medical procedures such as angioplasty or bypass surgery. Early detection plays a vital role in controlling the disease and preventing complications.

Who is most at risk of developing Peripheral Artery Disease?

Individuals who smoke, have diabetes, high blood pressure, or high cholesterol are at a higher risk. The likelihood also increases with age, particularly after 50, or with a family history of cardiovascular disease.

Where can I get a Peripheral Artery Disease (PAD) test near me in Gurgaon?

At Artemis Hospitals in Gurgaon, patients can undergo advanced vascular diagnostic tests, including the Ankle-Brachial Index (ABI) test, Doppler ultrasound, and CT angiography, for accurate and early detection of PAD.

Who should I consult for Peripheral Artery Disease (PAD) diagnosis and treatment in Gurgaon?

For PAD evaluation and treatment, it is best to consult a vascular specialist or cardiologist experienced in managing circulatory disorders. At Artemis Hospitals in Gurgaon, a dedicated team of vascular experts and heart specialists offers comprehensive diagnosis, advanced treatment, and personalised care for all stages of PAD.

Which is the best hospital near me in Gurgaon for Peripheral Artery Disease (PAD) diagnosis and treatment?

Artemis Hospitals in Gurgaon offers advanced facilities for PAD care, including vascular imaging, angioplasty, and bypass procedures. The hospital’s team of expert cardiologists and vascular specialists ensures accurate diagnosis and personalised treatment for every patient.