A primary care approach to the patient with claudication.
Peripheral arterial occlusive disease occurs in about 18 percent of persons over 70 years of age. Usually, patients who have this disease present with intermittent claudication with pain in the calf, thigh or buttock that is elicited by exertion and relieved with a few minutes of rest. The disease may also present in a subacute or acute fashion. Symptoms of ischemic rest pain, ulceration or gangrene may be present at the most advanced stage of the disease. In most cases, the underlying etiology is atherosclerotic disease of the arteries. In caring for these patients, the primary care physician should focus on evaluation, risk factor modification and exercise. The physician should consider referral to a vascular subspecialist when symptoms progress or are severe. While the prognosis for the affected limb is quite good, patients with peripheral arterial occlusive disease are at increased risk of myocardial infarction and stroke. Therefore, treatment measures should address overall vascular health.
Carman
T L
TL
Cleveland Clinic Florida, Fort Lauderdale 33309, USA.
Fernandez
B B
BB
D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D000077407:Cilostazol; D015444:Exercise; D006801:Humans; D010353:Patient Education as Topic; D010431:Pentoxifylline / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011320:Primary Health Care; D011674:Pulse; D012307:Risk Factors; D012720:Severity of Illness Index; D013664:Teaching Materials; D013777:Tetrazoles / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D014665:Vasodilator Agents; D000077407:Cilostazol; D010431:Pentoxifylline