Peripheral Arterial Disease: Pulse and Blood Pressure Measurement
Pulse and blood pressure measurements taken in different areas of the body help diagnose peripheral arterial disease.
In the legs, doctors will commonly feel for pulses in the femoral (groin), popliteal (back of the knee), posterior tibial (ankle), and dorsalis pedis (foot) areas. Other pulses often checked include the radial (wrist), brachial (forearm), and carotid (neck) areas.
The pulses are graded for record-keeping purposes so that doctors can keep track of how a person's pulse changes over time. Your doctor uses a number system to rate your pulse.
Your doctor will listen to your pulse with a stethoscope for a "whooshing" sound called a bruit (say "broo-E"). A bruit might mean there is a blockage in the artery.
For peripheral arterial disease, blood pressure might be taken at the ankles, toes, legs, and arms.
Blood pressures are typically taken with a blood pressure cuff. But blood pressure can be measured using catheters placed inside the arteries. Because the arteries are punctured, this is known as invasive blood pressure monitoring.
In most people, the resting ankle pressure is greater than the pressure at the crook of the arm, known as the brachial blood pressure. The ratio of the ankle pressure to the brachial pressure is called the ankle-brachial index (ABI).
Toe pressures can be measured with miniature blood pressure cuffs to check for poor blood flow in the toes.
Segmental leg pressures
Arterial pressure can be estimated in the upper thigh, above the knee, and in the upper calf by placing blood pressure cuffs at the appropriate levels. The pressures can be compared between the two legs or at different levels in the same leg.
Blood pressures can be measured at the elbow (brachial), forearm, or wrist. Large differences between pressures at the various levels suggest arterial blockage. As with toes, finger pressures can be measured.
Other Works Consulted
- Hirsch AT, et al. (2006). ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): A collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation, 113(11): e463–e654.
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer David A. Szalay, MD - Vascular Surgery
Current as ofOctober 26, 2013
Current as of: October 26, 2013
Author: Healthwise Staff
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