Claudication

Question 1

What is it

Answer 1

🔹 Pain/cramping in muscles due to poor blood supply (ischemia), occurs with activity, relieved by rest.
🔹 Most commonly due to peripheral artery disease (PAD).

Question 2

Clinical presentation

Answer 2

🔹 Intermittent muscle pain/cramping in legs (calves, thighs, buttocks).
🔹 Triggered by exercise, relieved by rest.
🔹 Other PAD signs: cool skin, weak pulses, hair loss, shiny skin

🟢 What does pain location indicate?
🔹 Calf pain → Superficial femoral artery disease.
🔹 Thigh pain → Common femoral artery disease.
🔹 Buttock pain → Aortoiliac disease (Leriche syndrome if with erectile dysfunction).

Question 3

Epidemiology

Answer 3

🔹 Affects ~5% of adults over 55.
🔹 More common in men.
🔹 Often underdiagnosed due to atypical symptoms.

Question 4

Age groups affected

Answer 4

🔹 Most common in adults over 50.
🔹 Rare in young people unless they have risk factors.

Question 5

Risk factors

Answer 5

🔹 Atherosclerosis (main cause)
🔹 Smoking 🚬 (strongest modifiable risk factor)
🔹 Diabetes
🔹 Hypertension
🔹 High cholesterol
🔹 Obesity
🔹 Chronic kidney disease
🔹 Sedentary lifestyle

Question 6

Clinical features

Answer 6

🔹 Diminished pulses 🚫💓
🔹 Delayed capillary refill ⏳
🔹 Skin changes (shiny, hair loss, pallor, dependent rubor)
🔹 Advanced cases: Ulcers, gangrene ⚠️

Question 7

Prognosis

Answer 7

🔹 Progressive if untreated.
🔹 20-30% worsen in 5 years.
🔹 3-6x higher risk of heart attack/stroke.
🔹 Severe cases → limb amputation risk 🦵⚠️
🔹 Can improve with lifestyle changes & treatment