PT - JOURNAL ARTICLE AU - Amjad AlMahameed AU - John R. Bartholomew AU - Sean P. Lyden AU - Douglas Joseph TI - The clinical presentation of peripheral arterial disease and guidance for early recognition DP - 2006 Oct 01 TA - Cleveland Clinic Journal of Medicine PG - S15--S21 VI - 73 IP - 10 suppl 4 4099 - http://www.ccjm.org/content/73/10_suppl_4/S15.short 4100 - http://www.ccjm.org/content/73/10_suppl_4/S15.full SO - Cleve Clin J Med2006 Oct 01; 73 AB - Most patients with lower extremity peripheral arterial disease (PAD) are asymptomatic. Although intermittent claudication is the classic presenting symptom in those who are symptomatic, PAD often presents atypically as a result of associated comorbidities. The differential diagnosis involves consideration of many nonvascular and nonatherosclerotic causes of exercise-associated leg pain. Weak or absent pulses are the hallmark physical finding of PAD, and the ankle-brachial index is the most efficient objective test for documenting it. PAD may progress to acute limb ischemia (acute deterioration of limb flow) or critical limb ischemia (chronic compromise in limb perfusion resulting in rest pain and tissue loss), both of which can lead to limb loss without timely treatment.