A rational approach to diagnosis and treatment of intermittent claudication

Am J Med Sci. 2002 May;323(5):244-51. doi: 10.1097/00000441-200205000-00003.

Abstract

Intermittent claudication (IC), the first recognizable symptom of peripheral arterial disease, is prevalent among older persons and associated with significant morbidity and mortality. The diagnosis of IC involves taking a thorough patient history, conducting a physical examination with an emphasis on the cardiovascular system, and noninvasive testing with functional assessment. The goals of treatment for IC are to prevent progression of vascular disease and cardiovascular complications and to improve exercise performance, functional status, and quality of life. The cornerstones of therapy are risk-factor modification, particularly smoking cessation, and exercise. In patients for whom non-pharmacologic therapy does not provide adequate pain relief and improvement in physical function, medical therapy with 1 of 2 drugs approved for the treatment of IC may be appropriate. Revascularization or intervention is generally reserved for patients with incapacitating disease. Early diagnosis of IC and implementation of effective therapy can reduce the development of morbidity and mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Blood Pressure Determination / methods
  • Cilostazol
  • Disease Progression
  • Exercise Test
  • Hematologic Agents / therapeutic use
  • Humans
  • Intermittent Claudication / diagnosis*
  • Intermittent Claudication / therapy*
  • Medical History Taking
  • Pentoxifylline / therapeutic use
  • Physical Examination
  • Risk Factors
  • Surveys and Questionnaires
  • Tetrazoles / therapeutic use
  • Vascular Surgical Procedures
  • Vasodilator Agents / therapeutic use

Substances

  • Hematologic Agents
  • Tetrazoles
  • Vasodilator Agents
  • Cilostazol
  • Pentoxifylline