Summary
Peripheral artery disease (PAD) is a common cardiovascular disease associated with increased risk of amputation, myocardial infarction, stroke, and death, as well as impaired quality of life (QOL), walking performance, and functional status. Detection of PAD in most patients is accomplished through the history, physical examination, and resting ankle-brachial index. Refer to the “2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease” for more guidance on the diagnosis and management of PAD. Part of the history and physical examination for a PAD diagnosis includes assessing for lower extremity symptoms that may suggest active PAD. For patients in whom the diagnosis of PAD has been established, longitudinal care includes periodic reassessment of lower extremity symptoms to monitor disease activity. Formula The following questions are pointed as follows. There are 21 points possible. A high value indicates higher severity of symptoms.1. Loss of feeling or tingling in the legs or feet?2. Toes that are pale, discolored or bluish?3. Feet that are cold to the touch or one foot that is colder than the other?4. Sores, wounds or ulcers on the legs or feet?5. Leg pain that disturbs your sleep or pain at rest?6. Aching, cramping or pain in your legs, calves, buttocks or thighs when you walk or exercise?7. Does the aching, cramping or pain in your legs, calves, buttocks or thighs when you walk or exercise persist even at rest?Never 0 pointsSometimes 1 pointOften 2 pointsAlways 3 points Results Symptoms suggestive of PAD > 0 pointsAsymptomatic0 pointsClaudication present & no history of heart failure or cardiomyopathy> 0 points on question #6 above and "no" on question, "Does the person have heart failure or cardiomyopathy?"Claudication present along with a history of heart failure or cardiomyopathy> 0 points on question #6 above and "yes" on question, "Does the person have heart failure or cardiomyopathy?" Recommendation If there are > 0 points on question #6 above and "no" on question, "Does the person have heart failure or cardiomyopathy?" then the following recommendation will appear: An individual with claudication and a diagnosis of peripheral arterial disease (PAD) may benefit from Cilostazol 75mg PO twice daily.Note: Cilostazol is contraindicated in heart failure and cardiomyopathy