Symptoms of peripheral arterial disease: A critical review

Peripheral arterial disease (PAD) is an atherosclerotic disease that leads to a narrowing of the arteries in the legs. This narrowing limits the amount of blood able to pass through the arteries. PAD is associated with significant morbidity and mortality, contributes to functional impairment, and can negatively impact quality of life. Claudication, the primary symptom of PAD, arises during activity when the blood and oxygen demand of the working skeletal muscle exceeds supply. The prevalence of claudication in patients with PAD varied from 4.5% to 54.4% in the articles reviewed. Variables that make understanding the symptom experience of PAD difficult include the type of population that research studies target, the wide range of definitions of claudication, and the lack of clear definitions regarding those who experience atypical symptoms or who are asymptomatic. This article reviews the literature related to the assessment, functional impairment, and symptom experience of patients with PAD, including a critique of the methods and findings of these studies. Education of health care professionals and the general public on what is known about PAD functional impairment and the symptom experience is greatly needed. Further research is needed. It is recommended to begin with qualitative research, which could then be used to improve quantitative assessments in those suspected of having PAD.