Peripheral Arterial Disease – Checking your foot pulse

Why do I check your foot (pedal) pulses?

In the main, I want to know what your blood supply to your foot is like. This gives me an indication of the function of your heart and how well the blood is getting to your feet. I may ask you questions about pain or odd sensations. If the blood flood is good, then this indicates that you will heal up well should you suffer any cuts to your skin.

There are important peripheral arterial conditions that affect the flow of blood to your feet and as Podiatrists we have these in our minds when we are looking at the foot in general and listening to your pulse.

The Doppler

Listening to a pulse with the Doppler can detect irregularity in the heart rate (arrhythmia). Referral on for further investigation can result in the recognition of undiagnosed atrial fibrillation. For people with atrial fibrillation, the risk of stroke increases fivefold.

Atherosclerosis and Arteriosclerosis

Both these terms are used to describe blockages in your blood vessels, but they are different in the types of vessels they affect. Atherosclerosis is a thickening of the wall of an artery caused by fatty deposits and leads to a narrowing or obstruction of the artery.
Arteriosclerosis is a normal ageing process where the internal and middle wall of the artery becomes thickened, increasing the rigidity of the vessel. This contributes to increased blood pressure in later years.

Arteriosclerosis plays a key role in disease progression, particularly in people with diabetes, renal disease or the very elderly.
Symptoms include; intermittent claudication (inadequate blood supply causing pain in exercise), ischaemic rest pain – burning pain, worse at night, located in the forefoot and toes.

Critical limb ischaemia requires urgent referral to a vascular surgeon.
Preventative heart attacks and strokes is a major objective within the NHS 10-year plan. Early diagnosis of peripheral arterial disease is a key way of improving cardiovascular outcomes, and as the lower-limb profession, Podiatrists are able to take the lead in this extremely important task.

Katrina Corby

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