What is intermittent claudication?
|A||Pain on 1st step|
|B||Pain on exercise only|
|C||Pain on last step|
|D||Pain at rest|
a. Cramp like pain felt in the muscles that is brought on by walking, not present on taking the first step (OA. relieved by standing still (IVD.
b. The distance walked is called the claudication distance.
c. Most commonly felt in the CALF, but can affect the thigh or the buttock.
d. Less common in the upper limb (writing or manual labour)
Clinical Syndromes of Atherosclerosis
a. During the initial phases of atheroma development, the plaque usually grows outward, in an abluminal direction.
b. Vessels affected by atherogenesis tend to increase in diameter, a phenomenon known as compensatory enlargement, in a type of vascular remodeling.
c. The growing atheroma does not encroach upon the arterial lumen until the burden of atherosclerotic plaque exceeds ~40% of the area encompassed by the internal elastic lamina.
d. Many such plaques cause stable syndromes such as demand-induced angina pectoris or intermittent claudication in the extremities.
e. In the coronary and other circulations, even total vascular occlusion by atheroma does not invariably lead to infarction.
f. The hypoxic stimulus of repeated bouts of ischemia characteristically induces formation of collateral vessels in the myocardium, mitigating the consequences of an acute occlusion of an epicardial coronary artery.