Fast Five Quiz: Peripheral Arterial Occlusive Disease Signs and Symptoms

Arnold S. Baas, MD

Disclosures

May 17, 2022

In the setting of claudication, the presence of both palpable pedal pulses in the limb decreases the likelihood of PAOD.

Lessened or absent pulses provide important clinical evidence of PAOD. Therefore, patients presenting with claudication should receive a complete lower extremity evaluation, including pulse examination and measurement of segmental pressures. The absence of one pedal pulse increases the likelihood of PAOD, while the absence of both pedal pulses suggests a high likelihood of PAOD. Specifically, the absence of a pulse signifies arterial obstruction proximal to the area palpated; for example, if no femoral artery pulse is palpated, significant PAOD is present in the aortoiliac distribution.

Palpation of pulses should be performed from the abdominal aorta to the foot, with auscultation for bruits in the abdominal and pelvic regions. The presence of an iliac, femoral, or popliteal bruit also increases the likelihood of PAOD, while the combination of a bruit with both pedal pulses nonpalpable translates to a very high likelihood of diagnosis.

Learn more about the presentation of PAOD.

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