A 61-year-old woman with a history of hypertension presented for evaluation of exertional left calf discomfort. Six months prior to presentation, she developed a dull pain in her left calf while climbing stairs. After climbing 2 flights of stairs, she had to stop and rest for approximately 15 seconds. She reported no pain at rest. The patient’s symptoms worsened and began interfering with her work. On physical examination, her heart rate was 82/min and blood pressure was 140/89 mm Hg. Her lower extremities were warm, with strength for femoral, popliteal, dorsalis pedis, and posterior tibial pulses at 2+ bilaterally. She had no history of spinal degenerative disease and did not have lower extremity arterial bruits, wounds, sensory deficits, edema, or hair loss. Results of an exercise treadmill ankle-brachial index (ABI) test are shown in the Table.
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Mehta A, Sperling LS, Wells BJ. Postexercise Ankle-Brachial Index Testing. JAMA. 2020;324(8):796–797. doi:10.1001/jama.2020.10164
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