Peripheral Arterial Disease and Intermittent Claudication

Key points

• • Peripheral arterial disease is a narrowing of the limb arteries, usually by atherosclerosis, that reduces blood flow to the muscles.
• • The classic symptom is intermittent claudication: a cramping pain in the calf on walking that is relieved by rest.
• • As the disease worsens, pain comes even at rest, especially at night, and is eased by hanging the leg down.
• • Signs include cold, pale legs, absent foot pulses, loss of hair and slow-healing wounds or ulcers.
• • The end stage is critical limb ischaemia with rest pain, ulcers and gangrene, threatening the loss of the limb.