The present invention relates to a device, system and method for monitoring of peripheral arterial perfusion of a subject. To enable distinguishing between low pulsatility caused by centralization or low cardiac output, the proposed device comprises an input (30) for receiving first detection data of a tissue region of a subject, said first detection data being acquired over time by detecting radiation reflected from and / or transmitted through tissue of the subject, and for receiving second detection data of a skin region of subject, said second detection data being acquired over time by detecting radiation received from said tissue region in response to coherent light being emitted towards said skin region, a PPG unit (32) for deriving a photoplethysmography, PPG, signal from said first detection data, a flow unit (34) for deriving, from said second detection data, a flow signal indicative of a flow of light scattering particles within the skin region, and an evaluation unit (36) for evaluating said PPG signal and said flow signal to obtain information on the peripheral arterial perfusion, wherein the evaluation unit is adapted to determine a state of low vascular compliance and / or a state of low cardiac output based on a combined evaluation of said PPG signal and said flow signal.