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Patients with peripheral arterial disease show variety of leg symptoms

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WESTPORT, CT (Reuters Health) – Patients with peripheral artery disease may be asymptomatic or suffer a wide range of leg symptoms besides those of intermittent claudication, researchers report in the October 3rd issue of The Journal of the American Medical Association.

Dr. Mary McGrae McDermott of Northwestern University Medical School in Chicago and colleagues sought to characterize leg symptoms and associated physical limitations in patients with lower-extremity peripheral artery disease.

They conducted a cross-sectional study of 460 patients with peripheral artery disease and 130 controls without such disease. The subjects completed questionnaires and underwent a variety of tests, including a 6-minute walk and repeated chair raises.

Altogether, 150 patients with peripheral artery disease were deemed to have intermittent claudication (IC), 88 had leg pain on exertion and rest, 131 had atypical exertional leg pain, and 91 had no exertional leg pain. In comparison with the IC group, the 88 patients who had leg pain on exertion and rest had significantly more neuropathy (5.6% versus 3.5%), diabetes mellitus (48.9% versus 26.7%) and spinal stenosis (20.8% versus 7.2%).

However, patients with IC had poorer functioning than the patients with atypical exertional leg pain, which included 41 patients without IC who were able to "walk through" leg pain and 90 patients without IC whose exertional leg pain caused them to stop.

Although "symptoms of intermittent claudication have been considered the most classical manifestation of peripheral arterial disease," Dr. McDermott told Reuters Health, "this study shows that peripheral arterial disease often presents atypically and is frequently asymptomatic. Functioning is impaired among all patients with peripheral arterial disease, regardless of symptoms."

The researchers call for further studies but suggest that "clinicians can use leg symptoms to gauge the degree of functional impairment associated with peripheral artery disease."

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