Intermittent claudication is seen in?

Appeared in: DSSSB - 29 August 2019 (Shift-2)

Explanation

Intermittent claudication is the hallmark symptom of Peripheral Arterial Disease (PAD).
It is defined as muscle pain, cramping, or fatigue that occurs during exercise and is relieved by rest.
The pain is due to ischemia, where narrowed arteries fail to deliver sufficient oxygenated blood to meet the metabolic demands of active muscles.
The most common location for claudication pain is the calf muscles.

Option A: Aortic aneurysm typically presents with deep, constant abdominal or back pain, or may be asymptomatic. It does not cause exertional leg cramps.
Option B: Angina pectoris is chest pain resulting from myocardial ischemia. The location of the pain (chest, arm, jaw) is different from claudication.
Option C: Myocardial infarction (heart attack) involves severe, persistent chest pain, often at rest, due to the death of heart muscle tissue. It is a medical emergency and does not present as intermittent leg pain.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology and clinical manifestation of intermittent claudication as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in identifying PAD by taking a careful history of leg symptoms and assessing peripheral pulses. Ankle-Brachial Index (ABI) measurement is a key nursing assessment.
Patient education is a cornerstone of PAD management. Nurses teach patients about the importance of a structured exercise program, meticulous foot care to prevent ulcers, and aggressive risk factor modification (smoking cessation, diet, medication adherence).
What if? If a patient with PAD reports leg pain even at rest (rest pain), this signifies a progression to critical limb ischemia. This is a more severe condition requiring urgent referral for revascularization to prevent limb loss.

How to Approach the Question

First, identify the key term in the question: 'Intermittent claudication'.
Recall the definition of intermittent claudication: exertional pain in the limbs (usually legs) caused by muscle ischemia, which is relieved by rest.
Analyze the options to see which disease process matches this pathophysiology.
Peripheral Arterial Disease (PAD) is characterized by atherosclerotic blockages in the arteries supplying the limbs, directly causing the supply-demand mismatch that leads to claudication.
Rule out the other options by recalling their primary locations and symptoms: Aortic aneurysm (aorta), Angina (heart/chest), Myocardial Infarction (heart/chest).

Concept Tested & Keywords

Concept Tested: Pathophysiology and clinical manifestation of intermittent claudication.
Stem keywords: Intermittent claudication
Lead-in keywords: seen in

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 65-67

E6 Medicine Harrison 22e Part 2 p. 76-78

Practise the full DSSSB - 29 August 2019 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.