Approximately half of people with peripheral artery disease do not experience any symptoms. For patients with symptoms, the most common symptoms are intermittent claudication and rest pain.

• Intermittent claudication: Intermittent claudication refers to pain or cramping in the arms or legs that occurs with exercise and subsides with rest. The severity and location of the pain of intermittent claudication vary depending upon the location and extent of blockage of the involved artery. The most common location of intermittent claudication is the calf muscle. The pain in the calf muscle occurs only during exercise such as walking, and the pain steadily increases with continued walking until the patient has to stop due to intolerable pain. Then the pain quickly subsides during rest. Intermittent claudication can affect one or both legs.

• Rest pain: Rest pain occurs when the artery occlusion is so critical that there is not enough blood and oxygen supply to the lower extremities even at rest. The pain typically affects the feet, is usually severe, and occurs at night when the patient assumes a supine position (lying down, face up).

Other symptoms and signs of peripheral artery disease include:

• Numbness of the extremities.
• Weakness and atrophy (diminished size and strength) of the calf muscle.
• A feeling of coldness in the legs or feet.
• Changes in color of the feet; feet turn pale when they are elevated, and turn dusky red in dependent position.
• Hair loss over the dorsum of the feet and thickening of the toenails.
• Painful ulcers and/or gangrene in tissue where there is critical ischemia (lack of blood and oxygen), typically in the toes.

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