Intermittent claudication is a symptom of chronic arterial insufficiency. The pain associated with intermittent claudication is related to the lack of oxygen to the tissues. Activity increases the oxygen requirements. With the compromised vessels, the tissues are starved for oxygen and pain is the result.
Objective observations are coolness, pallor, elevational pallor, and dependent rubor.
Pulses are diminished or absent, and ulcers develop. These ulcers occur at toes, metatarsal heads, heels, and lateral malleolus. The ulcers have well-defined edges, and a pale ischemic base. Blood pressure is determined in the ankle with a Doppler in the dorsalis pedis or posterior tibial artery. That systolic number is divided by the arm's systolic blood pressure.