Your doctor will review your medical history, your current symptoms and any medications you are taking.
Your doctor will ask you about your family history of heart disease, stroke and other circulatory problems, and your family history of high blood cholesterol. He or she will ask about cigarette smoking, your diet, and how much exercise you get,
Your doctor will measure your blood pressure and heart rate. He or she will examine you, paying special attention to your circulation. The exam includes feeling for pulses in your neck, wrists, groin and feet. Your doctor may check the blood pressure in your legs, to compare it to the pressure in your arms. The ratio of your blood pressure at your ankle to the blood pressure inside your elbow is called an ankle-brachial index or ABI.
Signs of poor impaired circulation include:
Cool skin that is pale or blue in the lower legs and feet
Bruits (the rough sound of turbulent blood flow through narrowed arteries) heard with a stethoscope in the neck, abdomen and groin.
An ABI of 0.9 or lower
Your doctor will order blood tests to measure your total, LDL and HDL cholesterol levels, triglyceride level, and fasting blood sugar. A routine electrocardiogram (EKG) occasionally will uncover electrical changes in the heart that indicate poor blood flow to the heart muscle. Your doctor may order an EKG performed during an exercise stress test if you have any symptoms suggestive of coronary artery disease.