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Intermittent claudication, also known as vascular claudication, is a symptom that describes muscle pain on mild exertion (ache, cramp, numbness or sense of fatigue), [1] classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest.
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
The main symptom is pain in the affected areas, at rest and while walking (claudication). [1] The impaired circulation increases sensitivity to cold. Peripheral pulses are diminished or absent. There are color changes in the extremities. The colour may range from cyanotic blue to reddish blue. Skin becomes thin and shiny. Hair growth is reduced.
Intermittent vascular (or arterial) claudication (Latin: claudicatio intermittens) most often refers to cramping pains in the buttock or leg muscles, especially the calves. It is caused by poor circulation of the blood to the affected area, called peripheral arterial disease .
Of patients with intermittent claudication, only "7% will undergo lower-extremity bypass surgery, 4% major amputations, and 16% worsening claudication", but stroke and heart attack events are elevated, and the "5-year mortality rate is estimated to be 30% (versus 10% in controls)". [84]
Symptoms may also include intermittent claudication or pain at rest. In late stages, paresthesia is replaced by anesthesia (numbness) due to death of nerve cells. [11] In severe cases, gangrene can occur suddenly and spread rapidly, [12] and should be treated within six hours of ischaemia. [13]
Exercise testing is a simplistic, non-invasive method of diagnosing intermittent claudication. Blood pressure measurements at the suspected area can be taken before and after exercise, as some symptoms only appear during strenuous activity. [3] Commonly, a treadmill setting at 2 mph with a 12-degree slope is utilized.
They later reported four more cases and claimed that the incidence of this pathology in patients younger than 30 years old with claudication was 40%. Servello was the first to draw attention to diminished distal pulses observed with forced plantar- or dorsiflexion in patients with this syndrome. [ 5 ]