Peripheral Arterial Disease

PAD is both a flow problem in the legs and a marker of diffuse atherosclerosis. Arterial narrowing limits oxygen delivery when skeletal muscle demand rises during walking; the same disease process raises the risk of myocardial infarction, stroke, and cardiovascular death. An abnormal leg test therefore changes more than the limb examination: it should trigger comprehensive cardiovascular risk reduction and foot protection. The diagnostic task has two layers. First, identify the pattern and urgency from the history and examination. Then confirm or refine the diagnosis with physiologic testing, adding imaging when treatment planning requires an anatomic map. A patient may have stable exertional claudication, chronic limb-threatening ischemia (CLTI), or acute limb ischemia (ALI); these are not interchangeable stages of one outpatient problem. For a Canadian NP, assessment and prescribing occur within provincial authority, local protocols, and formulary requirements. A threatened limb is not managed by routine follow-up alone; it requires prompt vascular involvement.