PVD- Peripheral vascular disease

Clinical manifestations

Approximately half of people with PVD do not experience any symptoms.

However, for the patients who do experience symptoms, the two most common

symptoms of PVD are intermittent claudication and rest pain. Other symptoms of

PVD include numbness, weakness, coldness, poor wound healing, hair loss, and

painful ulcers changes on the legs and feet (Porth,2004).

Intermittent claudication is a common symptom of PVD. Intermittent

claudication refers to arm or leg cramping when exercising and is relieved with

rest. The most common location of intermittent claudication is the calf muscle of

the leg. Rest pain, a more severe symptom, occurs in the legs when the vessel

occlusion is so severe that there is not enough blood and oxygen supply to the

legs. This pain is usually seen in the feet during the night.

Diagnostic Tests

There are several diagnostic tests used by doctors in order to identify or rule out Peripheral

Vascular disease (PVD). First, the Doctor may use a test such as the ankle/brachial index test or

treadmill exercise test. These tests will be used to observe the patients’ blood pressure. Next,

the doctor may use imaging tests such as an angiography, ultrasonography, or magnetic
resonance imaging to help locate blockages in the patients’ blood vessels. This is important in

helping the doctor select patients for further treatment or surgery.

The ankle/brachial index (ABI) can be used for a patient with symptoms that indicate

intermittent claudication. This test compares the blood pressure in the brachial with the blood

pressure in the ankle. The doppler ultrasound is used to measure the blood pressures behind the

knees and at the ankles. A patient with healthy blood vessels, should have pressures greater in

their legs than in the arms. An ABI of 0.9 to 1.3 is considered normal, an ABI less than 0.9

indicates the diagnosis of PVD (Atherosclerosis, 2018). Sometimes, the ABI test is followed by a

treadmill exercise test. For this test, the patient will walk on the treadmill for several minutes. The

blood pressure is taken in the arms and legs before and after the patient exercises. A significant

decrease in blood pressure indicates the diagnosis of PVD.

An angiography is the most accurate test used to detect the location of vessel obstruction.

A catheter is advanced from a small skin puncture, under X-ray assistance, to the arteries.

Because this test is invasive and can cause damage, it is not preferred. An angiography is only

used when a patient with severe peripheral vascular disease symptoms is considered for

surgery (Atherosclerosis,2018).

An ultrasonography is another test used to locate obstructions in the patient’s vessels. The

advantages to this test are that it is noninvasive and painless for the patient. The

ultrasonography uses sound waves to locate abnormalities in the vessels. These sound waves

are able to provide an image of the vessels and locate obstructions in blood flow.
 The Magnetic Resonance Imaging (MRI) is another imaging test used to locate obstructions

in blood flow. The MRI uses magnetism, radio waves to produce images of the vessels, locating

any obstructions in blood flow. The advantage of the MRI is that it is noninvasive and doesn’t

expose the patient to radiation from the X-ray.

Porth, Carol. (2004). Essentials of pathophysiology: concepts of altered health states.

Philadelphia: Lippincott Williams & Wilkins, 2004.

Atherosclerosis. (2018, November 13). Retrieved April 8, 2019, from

https://www.nhlbi.nih.gov/health-topics/atherosclerosis