Coronary vs. Peripheral Artery Disease: Key Differences, Symptoms & Treatment

Did you know that heart and blood vessel diseases are among the top causes of death in India? Coronary artery disease or CAD contributes to nearly one-third of all deaths in the country.

Peripheral artery disease or PAD is also increasingly common, especially among older adults and people with diabetes. These two conditions may seem similar at first glance, but they affect different parts of the body and present with different warning signs.

This blog breaks down the key differences between Coronary Artery Disease and Peripheral Artery Disease, helping you understand their treatment options, symptoms, and diagnosis.

What is CAD?

Coronary Artery Disease (CAD) occurs when the arteries that supply blood to the heart become narrow or blocked due to plaque buildup—a condition called atherosclerosis. This reduces oxygen supply to the heart and can result in chest pain (angina), fatigue, or even a heart attack.

Common Causes and Risk Factors:

• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Obesity
• Family history of heart disease
• Poor diet and lack of exercise

In India, the growing prevalence of sedentary lifestyles, processed food consumption, and stress has led to a sharp increase in CAD cases, even among people in their 30s.

What is PAD?

Peripheral Artery Disease (PAD) is a circulatory problem in which narrowed arteries reduce blood flow to your limbs, particularly your legs. Like CAD, PAD is caused by atherosclerosis, but it affects the peripheral blood vessels rather than the coronary arteries.

Causes and Who is at Risk:

• Smoking (a major factor)
• Diabetes
• High cholesterol or blood pressure
• Age (more common after 50)
• Family history of vascular diseases

PAD is especially concerning in diabetic patients in India, where poor foot care awareness can result in complications like infections, ulcers, and even amputations if PAD is left untreated.

CAD vs PAD: Key Differences

While both CAD and PAD stem from the same root cause—plaque buildup in the arteries—they differ in their symptoms, affected areas, and long-term risks.

Symptoms of Peripheral Artery Disease (PAD)

PAD often develops silently until it restricts blood flow severely. Recognizing early symptoms can prevent complications:

• Leg cramping or pain during walking (claudication)
• Numbness or tingling in legs or feet (can also be due to nerve damage)
• Cold sensations in lower limbs
• Shiny skin or slow-healing wounds on legs/feet
• Hair loss on the legs

Ignoring these signs can lead to non-healing ulcers or gangrene, especially in diabetic individuals. PAD legs treatment can begin with lifestyle changes and medication, but in moderate-to-severe cases, PAD angioplasty is often necessary to open blocked vessels and restore circulation.

Symptoms of Coronary Artery Disease (CAD)

CAD symptoms can be sudden or gradually worsen over time. Common indicators include:

• Chest tightness or pain, often during exertion
• Shortness of breath
• Unexplained fatigue
• Pain radiating to the jaw, neck, back, or arms
• Dizziness or irregular heartbeat

If not treated on time, CAD can lead to severe consequences like heart attacks or heart failure. Seeking timely Coronary Artery Disease treatment from a cardiologist is critical.

Diagnosis and Treatment Options

Diagnosing Coronary Artery Disease (CAD)

Diagnosing Coronary Artery Disease (CAD) typically begins with an evaluation of symptoms such as chest pain, shortness of breath, or fatigue. One of the first tests a doctor may recommend is an Electrocardiogram (ECG), which measures the heart’s electrical activity. This test can detect irregularities in heartbeat or past heart attacks and provide early clues about potential coronary issues.

Another important diagnostic tool is the Treadmill Test (TMT), also known as a stress test. This test evaluates how the heart performs under physical exertion by monitoring its rhythm, blood pressure, and symptoms while the patient walks on a treadmill. Abnormalities during the test may indicate reduced blood flow to the heart, a sign of blocked or narrowed arteries.

To confirm the presence and severity of blockages, doctors may perform a Coronary Angiography. This is considered the gold standard for diagnosing CAD. 

During the procedure, a contrast dye is injected into the coronary arteries through a catheter, and X-ray imaging is used to visualize the blood flow and detect any narrowing or blockages.

Diagnosing Peripheral Artery Disease (PAD)

The diagnosis of Peripheral Artery Disease (PAD) often starts with a physical examination and a review of symptoms such as leg pain while walking (claudication), cold feet, or non-healing wounds. 

One of the simplest and most effective tests for PAD is the Ankle-Brachial Index (ABI). This test compares blood pressure in the ankle with that in the arm. A lower pressure in the ankle suggests that the blood flow to the legs is reduced, indicating the presence of PAD.

In addition to ABI, a Doppler Ultrasound is commonly used. This non-invasive imaging test uses sound waves to measure the blood flow in the arteries of the legs. It helps to identify the exact location and severity of blockages or narrowing in the vessels.

For a more detailed assessment, especially in advanced or critical cases, Peripheral Angiography may be performed. 

Similar to coronary angiography, this test uses contrast dye and X-ray imaging to visualize the arteries in the legs and pinpoint specific blockages that may require intervention.

Coronary Artery Disease (CAD) Treatment

Once CAD is diagnosed, treatment usually begins with lifestyle changes aimed at improving heart health. A heart-healthy diet, regular exercise, quitting smoking, and managing stress are fundamental in slowing the progression of the disease. 

Alongside lifestyle modifications, medications play a crucial role. These often include blood thinners to reduce the risk of clots, statins to lower cholesterol levels, and beta-blockers to reduce the heart’s workload and control blood pressure.

In more advanced cases where medications and lifestyle changes aren’t enough, procedural interventions may be necessary. Angioplasty is a minimally invasive procedure in which a small balloon is inserted and inflated to widen the blocked artery, often followed by placing a stent to keep it open. 

In cases with multiple or complex blockages, coronary artery bypass grafting (CABG)—a surgical procedure that redirects blood around the clogged arteries—may be recommended.

Peripheral Artery Disease (PAD) Treatment

Treating PAD involves a combination of lifestyle interventions, medications, and in some cases, surgical procedures. The first and most effective lifestyle changes include quitting smoking, which significantly improves blood flow, and engaging in supervised walking exercises to enhance circulation in the legs. For diabetic patients, tight glucose control is essential to prevent the worsening of vascular damage.

Medications are prescribed to improve blood flow, reduce pain during walking, and prevent blood clots. These may include antiplatelet agents like aspirin or clopidogrel, and vasodilators that help widen the blood vessels.

In more severe or advanced stages of PAD, especially when patients experience critical limb ischemia or non-healing ulcers, procedures like PAD angioplasty are considered. This involves inflating a balloon inside the narrowed artery to restore blood flow, often followed by stent placement. 

In cases where angioplasty is not feasible or successful, surgical bypass may be performed to create a new path for blood to flow around the blocked artery.

Comparing Treatment Options for CAD and PAD

While there’s some overlap in treating CAD and PAD, each condition has its own specialized procedures:

Conclusion

Frequently Asked Questions (FAQs)