• Claudications
o Cramping in legs on exertion with relief with rest (intermittent claudication)
o Is the pain relieved by resting within 10 minutes
... [Show More] (intermittent claudication)?
o Symptomatic limb ischemia with exertion is usually atherosclerotic PAD. Pain with walking or prolonged standing, radiating from the spinal area into the buttocks, thighs, lower legs, or feet, is neurogenic claudication.
o Ankle–Brachial Index used to diagnose
o Present in Chronic Arterial Insufficiency (Advanced)
• Aneurysms
o An expanding hematoma from an abdominal aortic aneurysm (AAA) may cause symptoms by compressing the bowel, aortic branch arteries, or the ureters.13,14 Prevalence of AAAs in first-degree relatives is 15% to 28%.1
o These symptoms suggest mesenteric ischemia from arterial embolism, arterial or venous thrombosis, bowel volvulus or strangulation, or hypoperfusion. Failure to detect acute symptoms can result in bowel necrosis and even death.
o If the pain is relieved by sitting and bending forward, or if there is bilateral buttock or leg pain, the etiology is more likely to be spinal stenosis.16
o An exaggerated, widened femoral pulse suggests the pathologic dilatation of a femoral aneurysm.
o An exaggerated, widened popliteal pulse suggests a popliteal artery aneurysm. Popliteal and femoral aneurysms are uncommon. They are usually from atherosclerosis and occur primarily in men age ≥50 years.
o AAAs are detectable with abdominal ultrasound, which is a noninvasive, inexpensive, and accurate
• Acute arterial occlusion
o Acute arterial occlusion from embolism or thrombosis causes pain and numbness or tingling. The limb distal to the occlusion becomes cold, pale, and pulseless. Pursue emergency treatment.
o Arterial occlusive disease is much less common in the arms than in the legs. Absent or diminished pulses at the wrist occur in acute embolic occlusion and in Buerger disease, or thromboangiitis obliterans.
• Deep vein thrombosis (DVT)
o A painful, pale, swollen leg, together with tenderness in the groin over the femoral vein, suggests deep iliofemoral thrombosis. Risk of PE in proximal vein thrombosis is 50 [Show Less]