Coronary Artery Disease vs. Peripheral Artery Disease

Medically Reviewed by James Beckerman, MD, FACC on February 14, 2024
Written by Evan Starkman
6 min read

Coronary artery disease (CAD) and peripheral artery disease (PAD) have more in common than similar-sounding names. They’re both dangerous but treatable conditions that take a toll on blood vessels called arteries.

CAD or PAD can happen when plaque -- a substance made of fats, cholesterol, and other stuff -- builds up in the walls of arteries. Those are the blood vessels that carry blood between your heart and the rest of your body. This buildup can narrow or block an artery, limit blood flow, and raise your risk for serious health problems.

CAD affects the arteries that bring blood to your heart. It’s the main type of heart disease in the U.S. Some people don’t realize they have it until they have a heart attack. Over time, CAD can lead to heart failure, which is when your heart can’t pump enough blood to meet your body’s needs. Other possible complications include a problem with your heart’s rhythm or rate, called an arrhythmia.

PAD affects arteries that carry blood away from your heart to other parts of your body, usually your legs and feet. When you have this condition, it raises your risk for CAD and disorders that affect blood flow to your brain, which could make you more likely to have a heart attack or stroke.

Here’s a closer look at the similarities and differences between these two conditions.

Chest pain or discomfort is the most common symptom of CAD. Your doctor may call this angina. But sometimes, the first noticeable sign of CAD is a heart attack. Call your doctor or 911 if you have any of these heart attack symptoms:

  • Chest pain or pressure
  • Weakness, dizziness, nausea, or a cold sweat
  • Pain or discomfort in your arms or shoulder
  • Shortness of breath
  • Neck pain
  • Feeling more tired than usual

Lots of people with PAD, on the other hand, don’t notice symptoms. But if the condition affects the lower part of your body, it’s common to get painful cramps in your hips, thighs, or calves when you walk, climb, or exercise. The pain usually goes away a few minutes after you stop moving or exercising. Your doctor may call this type of cramping intermittent claudication.

It’s also possible to have PAD symptoms like:

  • Leg pain that doesn’t fade after you stop exercise
  • Weakness or numbness in your leg
  • Wounds on your foot or toe that don’t heal or heal slowly
  • Dark, dead tissue, typically on your toes, feet, fingers or hands, called gangrene
  • Coldness in your affected leg or foot
  • Discolored, blue, or pale leg or foot
  • Toe nails or leg hair that grows poorly
  • Erectile dysfunction, especially if you’re a man with diabetes

Most people who have PAD in their upper body don’t have symptoms.

Yes. Certain things can make you more likely to get either CAD or PAD, like:

Your family’s health history can play a role in either condition, too.

Your risk for CAD goes up if someone in your family:

  • Has heart disease
  • Develops heart disease at 50 or younger

Your chances of PAD go up if a family member has:

If you’ve had a heart attack or stroke, that also makes you more likely to get PAD.

No. Doctors use different tests to diagnose coronary artery disease and peripheral artery disease.

Some tests for CAD are:

Blood tests. These check things like your levels of cholesterol, blood sugar, and blood fats called triglycerides.

Electrocardiogram. This test uses painless electrodes on your body to check your heart’s rhythm.

Coronary calcium scan. This uses a series of X-rays to look for signs of buildup in your coronary arteries.

Stress tests. Your doctor monitors your heart to see how it responds to physical activity, like walking or running on a treadmill or biking on a stationary bike.

Cardiac magnetic resonance imaging (MRI) scan. This imaging test uses a magnetic field and radio waves to check for tissue damage or blood flow problems in your heart or coronary arteries.

Cardiac PET scan. This imaging test uses tiny cameras and a radioactive substance to spot problems with how blood flows through small coronary blood vessels and into your heart.

Coronary angiography. This procedure uses X-rays and contrast dye to help your doctor see inside your coronary arteries. Your doctor uses a long, thin, flexible tube called a catheter to inject the dye.

Coronary computed tomography (CT) angiography. This is a less invasive type of coronary angiography. It doesn’t involve a catheter.

Some tests that can help your doctor diagnose PAD are:

Ankle-brachial index (ABI) test. Your doctor uses a blood pressure cuff and ultrasound to compare the blood pressure in your ankle with the blood pressure in your arm.

Blood tests. These check your cholesterol, triglycerides, and blood sugar.

Exercise ABI test. This involves walking on a treadmill so your doctor can see how severe your leg symptoms are and how physical activity affects your symptoms.

Six-minute walking test. Your doctor measures how far you can walk down a hallway in 6 minutes.

Doppler ultrasound. This imaging test uses soundwaves to spot areas of reduced or blocked blood flow and to measure how quickly blood travels through your arteries.

Segmental Doppler pressure testing. This uses ultrasound and blood pressure cuffs on different parts of your leg to check for narrowed or blocked arteries.

CT angiography. This test uses injected dye and X-rays to check your arteries for blockages. Some versions of this use a long, thin, flexible tube called a catheter to inject the dye.

MRI angiography. This uses radio waves, a magnet, and sometimes injected dye to make pictures of your arteries.

The type of treatment you need for coronary artery disease depends on things like how serious your condition is and how severe the symptoms are.

Some medicines for CAD are:

ACE inhibitors and beta blockers. These help lower your blood pressure.

Calcium channel blockers. These also lower blood pressure.

Blood sugar meds. These help keep your glucose (blood sugar) in check.

Metformin. This drug controls the buildup of plaque in your arteries if you have diabetes.

Nitrates. These dilate your arteries and ease or prevent chest pain.

Ranolazine. This drug treats damage to the inner walls of your coronary arteries and the pain that comes along with it.

Statins or other cholesterol meds. These help lower high cholesterol.

If you have advanced CAD and medications don’t help, your doctor may recommend one of these procedures:

Percutaneous coronary intervention. This nonsurgical procedure opens narrowed or blocked arteries and improves blood flow to your heart.

Coronary artery bypass. This surgery uses one of your healthy chest arteries and leg veins to reroute blood around blocked coronary arteries.

Transmyocardial laser revascularization or coronary endarterectomy. These surgeries can treat severe angina (chest pain) when other treatments are too risky or don’t help.

Some medications for peripheral artery disease are:

Antiplatelet drugs. These keep blood clots from forming, which could narrow affected arteries even more. Antiplatelet meds also lower your chances of having a heart attack or stroke.

Statins. These slow plaque buildup to keep it from getting worse. They also lower your chances of more serious problems from PAD.

Ace inhibitors and angiotensin II receptor blockers. These or other meds can help lower blood pressure and keep blood vessels from narrowing.

If meds and lifestyle changes don’t help, your doctor may recommend procedures for PAD such as:

Angioplasty. This opens narrowed or blocked arteries without surgery.

Bypass surgery. This procedure uses one of your healthy blood vessels (or an artificial one) to make a path around a blocked artery.

Yes. It’s important to practice healthy habits whether you have CAD or PAD.

Some key lifestyle changes for both conditions are: