Peripheral Artery Disease (PAD) is a common circulation problem in which arteries carrying blood to the legs are not functioning well or become narrowed or clogged due to a build-up of plaque.
Answer the following questions:
1. Have you ever been diagnosed with Peripheral Vascular Disease or been diagnosed as having poor circulation?
( Yes | No )
2. Have you ever had surgery, balloon procedure or stents in your heart, kidneys, belly, legs or arms?
( Yes | No )
3. When you walk, do you experience aching, cramping or pain in your legs, thighs or buttocks?
( Yes | No )
4. If you answered Yes to #3, when do you feel pain:
- After walking one block______
- Climbing a flight of stairs______
- After walking 100 yards______
- Walking at increased speed______
5. If you have pain, does the pain subside with rest?
( Yes | No )
6. Do your feet or toes bother you most nights while lying in bed, with relief when they are dangled at the edge of the bed?
( Yes | No )
7. Do you have any painful sores or ulcers on legs or feet that do not heal?
( Yes | No )
8. Are your legs discolored or bluish?
( Yes | No )
9. Answer all that apply:
- ____I am a current smoker
- ____I have a history of smoking
- ____I have diabetes
- ____I have a family history of diabetes
- ____I have high cholesterol
- ____I have a family history of high cholesterol
- ____I have high blood pressure/hypertension
- ____I have a family history of high blood pressure/hypertension
- ____I have coronary artery disease (CAD)
- ____I have a family history of coronary artery disease
- ____I have had a stroke/mini-stroke/TIA
- ____I have a family history of stroke/mini-stroke/TIA
If you answered yes to any of the above questions, you may have Peripheral Artery Disease (PAD). Please contact your Primary Care Physician to review this assessment and further recommendation.
