Symptoms of Peripheral Artery Disease (PAD)

Peripheral Artery Disease, or PAD, is disease of the blood vessels outside the heart. You will experience different symptoms based on where the artery problems are.

  • Signs of PAD in the Legs
  • Signs of PAD in the Arms
  • Signs of Carotid (Neck) Artery Disease
  • Signs of Kidney (Renal) Artery Disease
  • Signs of Aortic Disease

Signs of PAD in the Legs

Because PAD in the legs develops gradually over time, women in the early stages of the disease may not have any symptoms at all. As the disease progresses, most patients will experience one or more of these common symptoms:

  • Cramping, aching, numbness, tiredness, weakness, or burning in your buttock, thigh, calf or foot that occurs when walking and goes away when you rest. This pain or discomfort is called intermittent claudication. It does not usually occur while sitting or standing still.
  • Numbness in your legs or feet when you are at rest. Your skin may appear pale and feel cool to the touch.
  • Foot or toe pain or tingling that does not go away with rest, and may disturb your sleep. The pain may be worse when the leg is elevated and improve when you hang your legs over the side of the bed.
  • A feeling that the hip or leg is “giving out” during walking
  • Skin wounds or ulcers on your legs or feet that heal slowly or don’t heal at all

At first, leg pain during exercise may only be present when you walk uphill or long distances, but the pain may gradually become apparent with less and less exertion. Some women may not notice they have symptoms because they slow their walking speed or avoid walking (consciously or unconsciously) to avoid leg pain.

While claudication is considered the “classic” sign of PAD, most women and men with PAD do not have typical leg symptoms during exercise. About half of women with PAD have leg symptoms other than claudication. Many women do not experience leg pain at all, and the only way to tell that they have PAD is during a doctor’s examination.

Although many women do not think of leg pain or tiredness as a serious problem, pain in your legs is not a normal sign of aging. Proven treatments are available to relieve PAD symptoms and prevent complications, so be sure to discuss with your doctor any symptoms you experience.

Signs of PAD in the Arms

Although PAD is most common in the legs, the arteries in the arms can also become blocked or narrowed by the buildup of fatty deposits on the lining of the arteries (atherosclerosis). Like other forms of PAD, arm artery disease tends to develop gradually and you may not notice any symptoms at first.

The most common symptom of arm artery disease is intermittent claudication: pain in your arm that happens when you are using your arm and goes away when you rest. This pain may be felt as aching, tightness, heaviness, cramping, or weakness.

If you measure your own blood pressure at home, differences of 12 to 15 points or more between your two arms may be a sign that the arteries in one arm are blocked or narrowed. Other symptoms include finger pain, fingers that turn blue or pale, sensitivity to cold in your hands, or a lack of pulse in your wrist or hand. As the disease progresses, you may notice sores or skin that is pale or cool to the touch on your arm or hand.

If you experience the symptoms of arm artery disease, make an appointment with your doctor right away. The earlier you are treated the better chance you have of getting the disease under control before you experience serious complications, including heart attack and stroke.

Signs of Carotid Artery Disease

Carotid Artery Disease affects blood flow through the carotid arteries, the two large vessels (one on each side of your neck) that supply blood to the brain. Because it often causes no symptoms in the early stages, it is important to see your doctor for regular physical examinations. She or he can use a stethoscope to detect some blood flow problems in the neck before they cause serious complications. (See How is carotid artery disease diagnosed?)

Unfortunately, the first symptom of carotid artery disease is often a stroke or TIA (“mini-stroke”) caused by blocked blood flow to the brain. If you have any of these symptoms, call 9-1-1 immediately:

  • Sudden numbness or weakness of face, arm, or leg, especially on only one side of the body
  • Sudden confusion or trouble speaking or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, or loss of balance or coordination
  • Sudden severe headache with no known cause

Stroke symptoms that go away quickly after a short time may be caused by a TIA, a warning sign that a full stroke may happen soon. One in 10 people who have a TIA will have a stroke within 90 days. If you experience any of the above symptoms, even if they go away after a short time, you need to seek treatment to prevent a full stroke.

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Signs of Kidney (Renal) Artery Disease

Renal artery disease is PAD in the arteries that supply blood to the kidneys. In the early stages it usually does not cause symptoms, and is often discovered in patients who are undergoing evaluation for other problems such as coronary artery disease or high blood pressure, or on routine blood tests (see How is Kidney Disease Diagnosed?)

The kidneys control blood pressure, so high blood pressure is often the first sign of renal artery disease. Signs that your high blood pressure may be related to kidney problems:

  • You are younger than 30 years old
  • You are 55 or older and have severe high blood pressure (160 mm Hg systolic or 100 mm Hg diastolic or higher)
  • Your high blood pressure has suddenly gotten worse
  • Your blood pressure has not gone down after treatment with high blood pressure drugs
  • You have high blood pressure that is causing kidney damage, heart failure, or vision or nerve problems

Other symptoms that may be related to kidney artery disease include:

  • Sudden unexplained fluid buildup in the lungs that causes difficulty breathing, and sometimes coughing up blood, sweating, anxiety, and pale skin (called pulmonary edema)
  • Symptoms of heart failure
  • Chest pain (angina) that has not responded to standard treatments

Signs of Aortic Disease

The aorta is the largest artery in the body. It carries oxygen-rich blood from the heart’s main pumping chamber (the left ventricle) and distributes it to the arteries that branch off the aorta and carry blood to the rest of the body.

Aortic aneurysms, the most common form of aortic artery disease, usually do not cause symptoms in the early stages. However, as they grow bigger they may cause symptoms when they put pressure on nearby organs.

Symptoms of thoracic (chest) aortic aneurysm:

  • Deep, aching or throbbing chest pain
  • Back pain
  • Cough or shortness of breath
  • Hoarseness, difficult or painful swallowing

Symptoms of abdominal (belly) aortic aneurysm:

  • Abdominal pain or discomfort; can be constant or come and go
  • Pain in the chest, abdomen, lower back, or flank that can spread to the buttocks, groin, or legs; lasts for hours or days
  • A pulsating feeling in the abdomen
  • Feeling of fullness after minimal food intake
  • Fever or weight loss
  • Rarely, you may have pain, discoloration, or sores on the toes or feet because of a plaque or a blood clot that has broken off from the aneurysm and become lodged in a blood vessel in your leg

If an aortic aneurysm grows large enough, it may break open (rupture), causing severe internal bleeding that is deadly if not treated immediately. If you have any of these signs of a ruptured aortic aneurysm, call 9-1-1 immediately:

  • Sudden severe chest or upper back pain, often described as a tearing or ripping sensation
  • Feeling dizzy or lightheaded or passing out
  • Weakness or trouble standing up
  • Confusion, anxiety, loss of alertness

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  1. Lloyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics–2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. Jan 27 2009;119(3):e21-181.

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