Intermittent Claudication

A symptom of peripheral arterial disease (PAD) characterised by muscle pain (often calf pain) that occurs during physical activity and is relieved by rest.

• Caused by reduced blood flow to the leg muscles due to atherosclerosis in the peripheral arteries.
• Insufficient oxygen supply (ischaemia) to the muscles during activity.

• Smoking
• Diabetes mellitus
• Hyperlipidaemia
• Hypertension
• Age over 50
• Family history of cardiovascular diseases

• Pain, cramping, or fatigue in the leg muscles (often calves) during walking or exercise.
• Relief of symptoms with rest.
• Decreased or absent pulses in the affected limb.
• Atrophic skin changes, hair loss on the leg.
• Delayed wound healing, especially on feet.

• Ankle-brachial index (ABI): Ratio of blood pressure at the ankle to the arm. A decreased ratio indicates PAD.
• Doppler ultrasound: Evaluates blood flow and identifies blockages or narrowing.
• Angiography (either magnetic resonance angiography or contrast angiography).
• Treadmill exercise test to reproduce symptoms and measure severity.

• Conservative: Supervised exercise programmes to improve walking distance.
• Medical: Antiplatelet agents (e.g., aspirin or clopidogrel) and statins to reduce cardiovascular risk.
• Interventional: Angioplasty with or without stent placement, bypass grafting.

• Progression to critical limb ischaemia.
• Increased risk of myocardial infarction and stroke due to systemic atherosclerosis.

• Smoking cessation.
• Regular exercise.
• Control of blood sugar, cholesterol, and blood pressure.
• Maintaining a healthy weight and diet.