Match each clinical vignette describing a distinct peripheral vascular presentation to its most appropriate anatomic diagnosis or pathophysiologic syndrome.
- A patient with a heavy smoking history experiences predictable left calf cramping after walking three blocks, which resolves after a few minutes of rest. Examination shows strong femoral pulses but non-palpable popliteal and pedal pulses on the left.Femoropopliteal occlusive disease
- A patient with long-standing hyperlipidemia reports bilateral buttock and thigh aching during exertion, alongside newly developed erectile dysfunction. Physical examination reveals symmetrically absent femoral pulses bilaterally.Aortoiliac occlusive disease (Leriche syndrome)
- A patient with unmedicated chronic atrial fibrillation abruptly develops a severely painful, pale, and cold right leg. The patient has no prior history of exertional leg pain. Pulses are absent below the femoral level.Acute embolic arterial occlusion
- A patient reports intermittent dizziness and vertigo that is reliably provoked by vigorous exercise of the left arm. Blood pressure in the left arm is measured to be 35 mm Hg lower than in the right arm.Subclavian steal syndrome
Answer
The presentations map to their anatomic origins as follows: Calf claudication with intact femoral pulses indicates femoropopliteal occlusive disease. Buttock claudication, absent femoral pulses, and impotence characterize aortoiliac occlusive disease (Leriche syndrome). The abrupt onset of a pale, pulseless leg in atrial fibrillation denotes acute embolic arterial occlusion. Arm exertion triggering vertigo with asymmetric blood pressure is classic for subclavian steal syndrome.
Each clinical vignette is uniquely characterized by its physical exam findings and history, which directly correlate to specific anatomic lesions and vascular pathophysiologies.
Step-by-Step Solution
Key Concept
Anatomic Localization of Peripheral Vascular Pathologies