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A 52-year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except for decreased hair on the right leg. The patient's popliteal, dorsalis pedis, and posterior tibial pulses were markedly decreased compared with those of his left leg.
Diagnostic Analysis
With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography to document the location of the vascular occlusion. The patient underwent a bypass from the proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.
Discussion Question 1. What was the cause of this patient's pain and cramping?
Discussion Question 2. Why was there decreased hair on the patient's right leg?
Discussion Question 3. What would be the strategic physical assessments after surgery to determine the adequacy of the patient's circulation?
Discussion Question 4. What would be the treatment of intermittent Claudication for non-occlusion?
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