Peripheral Arterial Disease: Medical Care and Prevention of Complications

David L. Dawson, MD; William R. Hiatt, MD; Mark A. Creager, MD; Alan T. Hirsch, MD


Prev Cardiol. 2002;5(3) 

In This Article

Functional Impact of PAD

Claudication, an important symptom associated with PAD, is experienced as either leg pain when walking or simply as walking-related fatigue or discomfort. It has a significant and measurable impact on overall functioning and quality of life. A decrease in functional capacity is correlated with the severity and extent of PAD. Although claudication is the most common symptom of PAD, patients may have impaired walking performance, often without recognizing or reporting classic symptoms of exertional leg pain.[14] However, careful questioning of such patients may lead to an accurate diagnosis of PAD, because whether or not they report claudication symptoms, they may report a decrement in walking speed and shorter walking distances, both indicative of a positive diagnosis.[15,16]

Moderately severe claudication significantly reduces a patient's ability to exercise. Peak oxygen consumption may be reduced by as much as 50%. By comparison, this reduction approximates the decrement in physical performance capability seen with New York Heart Association class III congestive heart failure.[17] Thus, the decrement in physical performance is of a magnitude that warrants definitive medical attention. Further, the physical disability attributable to PAD may further exacerbate long-term cardiovascular risk, as it limits a patient's ability to derive other benefits of aerobic exercise and conditioning of leg skeletal muscles.