ACCSAP CCKE Coronary Artery Disease (CAD): Risk Stratification and Prevention Practice Test

When resting measurements look normal but there is still strong suspicion for PAD, the test strategy should focus on how the arteries respond to exercise. A normal or high resting ABI can occur even with disease, especially if vessels are calcified or if symptoms only appear with activity. Post-exercise (treadmill) ABI testing uncovers flow limitation that isn’t evident at rest. If the ankle pressure falls significantly after exercise—or if the post-exercise ABI drops to around 0.90 or less—it indicates hemodynamically significant PAD despite a normal resting result. This approach is noninvasive and guides further steps, such as duplex ultrasound or targeted imaging if PAD is confirmed. Immediate CTA/MRA or surgical intervention isn’t warranted based solely on resting ABI with ongoing suspicion, and simply ignoring symptoms isn’t appropriate.