Difference in Blood Pressure or Pulse Between Arms and Legs

CLINICAL DIAGNOSTIC MANUAL

A difference in blood pressure or pulse between the arms and legs is an important clinical sign that may indicate the presence of serious vascular diseases. This discrepancy can suggest obstructions or abnormalities in the major arteries, affecting blood flow to the extremities. Identifying the underlying cause is essential for accurate diagnosis and to prevent severe complications such as limb ischaemia.

Pathology	Suspected Diagnosis	Confirmatory Diagnosis
Atheromatous arterial thrombosis	Difference in blood pressure, intermittent claudication, coldness in affected limbs.	Arterial Doppler ultrasound, angiography.
Thoracic or abdominal aortic aneurysm	Chest or abdominal pain, pulsatile mass, difference in blood pressure.	Aortic CT or MRI, echocardiogram.
Aortic coarctation	Hypertension in arms, low pressure in legs, heart murmur, leg claudication.	Aortic CT or MRI, echocardiogram, angiography.