normal or low blood pressure. Individuals with ventricular tachycardia may present with fainting or in an unconscious state.
Diagnostic tools used to screen for ventricular tachycardia and assess for causes include electrocardiogram, echocardiogram, Holter monitor, intracardiac electrophysiology studies, event recorder, chest x-ray, magnetic resonance imaging, and thyroid function tests. Also, blood work may be completed to access other contributing factors including thyroid function tests, electrolyte levels, and metabolic function tests.
Intermittent claudication
Intermittent claudication is a condition that arises from peripheral arterial disease. Approximately one-third to one-half of individuals diagnosed with peripheral arterial disease present with intermittent claudication. The condition occurs after physical exertion and consists of pain during physical activity, which resolves once the activity is stopped. The pain most commonly occurs in the calves, thighs, and/or buttocks.
The condition is defined as muscle pain or cramping in appendages triggered by walking and physical activity. Individuals may also experience ischemic rest pain. The condition results from inadequate oxygen supply to the legs because of impeded blood flow.
Intermittent claudication occurs more commonly in men than women. It also occurs more often in individuals with a history of smoking, cardiovascular comorbid conditions, diabetes, and high blood pressure. The estimated prevalence of intermittent claudication is approximately 4.5 million individuals. It has been estimated that 60% to 70% of individuals with intermittent claudication have persistent symptoms, 20% to 25% symptoms get worse, and 10% require surgical intervention. The rate of amputation is approximately 1% to 2% per year.
Causes and risk factors
Intermittent claudication is most commonly associated with peripheral arterial disease. Both genetic and environmental factors can contribute to the onset of intermittent claudication.
The risk factors and causes for intermittent claudication are very similar to peripheral arterial disease as the former is a symptom of the latter. Conditions that can lead to intermittent claudication include blood clots, injury to limbs, and unusual anatomy of ligaments or muscles or infection. Other diseases that can lead to onset of peripheral vascular disease include aortic aneurysms, Buerger’s disease, pulmonary embolism, phlebitis, varicose veins, and Raynaud’s syndrome.
Factors that increase an individual’s risk for peripheral arterial disease and intermittent claudication include smoking, 50 years of age or older, diabetes, obesity, high blood pressure, high cholesterol or family history of cardiovascular diseases and/or arthrosclerosis. Male individuals of African American descent as well as overweight individuals and those with a family history of cardiovascular disease are at a higher risk of peripheral vascular disease and intermittent claudication.
Symptoms
The main symptoms of intermittent claudication include pain in a functional muscle group located in the legs such as calf, buttock, and thigh, pain after strenuous activity such as brisk walking or physical activity, and reduction of pain once physical activity is stopped.
The symptoms of intermittent claudication are associated with other symptoms of peripheral arterial disease including leg numbness or weakness, cold legs and feet, sores or wounds on digits or extremities that will not heal, blue or pale hue to legs, feet, hands and/or arms, hair loss on feet and legs, and changes in composition of nails.
Diagnosis and screening
The symptoms of individuals with intermittent claudication may vary. Therefore, practicing clinicians should assess the patient’s medical history, presence of comorbid conditions and examine the patient. Physical examination, medical history, and diagnostic screening tools are used to determine if a
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