Leg pain isn’t a typical early sign of a heart attack. But it could be a symptom of peripheral artery disease, which could increase your risk of a serious cardiovascular event like heart attack or stroke.

Everyone experiences aches and pains in their leg from time to time. Causes range from short-term cramps to chronic arthritis or from a recently pulled muscle to long-developing nerve damage.

In many cases, the root of the problem is in your leg itself. But your body’s systems are highly interconnected. Pain in your leg can be a sign of a wider health issue.

If you’re at high risk of developing heart disease, your leg pain could be due to peripheral artery disease (PAD). PAD shares many causes and risk factors with coronary artery disease (CAD) and can be an early sign.

This article will review the connection between your heart health and leg pain. Keep reading to learn how to determine whether your leg pain might be a sign of a more serious heart problem.

Your body’s circulatory system sends blood to the most important areas in high amounts. This includes the brain, heart, and kidneys. Your body has to work against gravity to get blood from your legs and feet back to your heart. This means your legs and feet are vulnerable to affected blood flow.

Here are some of the ways heart conditions can cause leg pain:

Of these three conditions, PAD is most common and often goes undiagnosed. It affects about 6.5 million people ages 40 and older in the United States.

Is leg pain a symptom of a heart attack?

Leg pain isn’t a symptom of a heart attack, but it can be a sign of heart disease. You may be experiencing the effects of PAD. In a 2019 study, about 5 percent of people with PAD experienced a heart attack within 30 months.

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PAD is a condition that causes the arteries in your arms and legs to narrow, affecting blood flow. PAD most commonly affects the legs and feet.

CAD, the most common form of heart disease, and PAD have the same cause: atherosclerosis. That’s when your arteries narrow due to plaque buildup. As a result, PAD can increase your risk of heart attack and stroke.

To be clear, not everyone with PAD has severe CAD. But PAD is a risk factor and can be a sign for you and a doctor to review your heart health. According to a 2019 review, about 46 to 68 percent of people with PAD also have CAD or cerebrovascular disease.

Risk factors for PAD include:

  • diabetes
  • smoking
  • obesity
  • hypertension
  • being age 50 or older
  • a family history of heart disease or stroke

According to a 2021 study, Black Americans have a much higher incidence of PAD. They’re also more likely to go without a diagnosis or without receiving timely treatment. The study suggests this is likely due to disparities in healthcare access and quality, lack of awareness of PAD in the community, and stereotype threat.

Ideally, pain shouldn’t be an everyday experience. You can usually link pain back to an activity or injury. Examples include challenging your muscles in the gym or experiencing a fall and hurting your leg.

When your leg pain becomes the rule and not the exception, it’s time to get concerned. You should be most concerned if the pain worsens with any physical activity, such as walking. This is because your body is signaling to you that something is wrong with the blood flow to your legs.

You should be especially worried if you experience pain in your legs and chest. This signals a potential lack of blood flow to the heart and could even mean you’re at increased risk of heart attack.

Signs of a heart attack

A heart attack can cause symptoms beyond chest pain or chest discomfort. Examples of these heart attack signs include:

  • dizziness
  • jaw pain or discomfort
  • nausea
  • pain in the arm, back, neck, or shoulder
  • shortness of breath
  • unexplained fatigue

Women are more likely to have unusual symptoms, such as nausea and unexplained tiredness.

If you notice these signs or symptoms, call 911 or local emergency services. Don’t attempt to drive to the hospital.

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PAD can cause the following symptoms:

  • aching legs
  • fatigue
  • leg cramping
  • leg pain

These symptoms usually worsen with physical activity, such as climbing stairs. When resting, the pain will usually resolve.

The condition can also cause physical changes to your body, especially your legs. These symptoms include:

  • difficulty feeling pulses on the feet and lower legs
  • muscle weakness or muscle loss
  • nonhealing ulcers on the feet or legs
  • skin that feels cool to the touch
  • smooth, shiny skin on the lower legs
  • toes that are cold to the touch or may feel numb

PAD symptoms are the result of claudication, or reduced blood flow. The lack of blood flow affects healing and can cause the legs to feel cool to the touch.

Healthcare professionals treat PAD through several different approaches:

  • Reducing your risk of blood clots. If you smoke, a doctor will ask you to stop. Smoking increases your risk of blood clots. A doctor also may prescribe medications to reduce your risk of blood clots, such as aspirin or antiplatelet medications like clopidogrel (Plavix) or warfarin (Jantoven).
  • Reducing your cholesterol. High cholesterol leads to deposits in the blood vessels that further narrow them. Taking medications, such as statins, to lower cholesterol can reduce your risk of worsening PAD. Eating a healthy diet can help too.
  • Surgery. If you experience significant changes to your arteries, you may need surgery to “bypass” the blockages. This surgical approach is like rerouting traffic to a clear lane. However, doctors only use this approach for those with severe PAD.

These treatments can not only reduce your pain with physical activity but also reduce your risk of heart attack and stroke.

Adopting the following habits can help reduce your risk of PAD:

Pain in your leg doesn’t automatically mean that there’s a problem with your heart. Still, it’s best not to ignore your leg pain.

If your leg pain persists (and especially gets worse with physical activity), talk with a doctor about potential causes. A doctor can perform testing to determine whether affected blood flow could be the underlying cause.

PAD can be an early sign of a potentially fatal heart attack or stroke. Getting an early diagnosis from a doctor and making key lifestyle changes might help prevent more serious complications.