Which clinical history findings are characteristic of peripheral arterial occlusive disease (PAOD)?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Intermittent claudication typically causes pain that occurs with physical activity. Determining how much physical activity is needed before the onset of pain is crucial. Typically, vascular surgeons relate the onset of pain to a particular walking distance expressed in terms of street blocks (eg, two-block claudication). Using some standard measure of walking distance helps quantify patients’ condition before and after therapy.

Other important aspects of claudication pain are that the pain is reproducible within the same muscle groups and that it ceases with a resting period of 2-5 minutes.

The location of the pain in patients with peripheral arterial occlusive disease (PAOD) is determined by the anatomic location of the arterial lesions. PAOD is most common in the distal superficial femoral artery (located just above the knee joint), a location that corresponds to claudication in the calf muscle area (the muscle group just distal to the arterial disease). When atherosclerosis is distributed throughout the aortoiliac area, thigh and buttock muscle claudication predominates.

The perceived significance of claudication is variable. Most patients appear to accept a decrease in walking distance as a normal part of aging. Investigators report that 50-90% of patients with definite intermittent claudication do not report this symptom to their clinician.

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