Jeannie K. Chang, Keith D. Calligaro and Matthew J. Dougherty
A 62-year-old overweight postal worker presented with complaints of cramps in his right calf. He stated that this reproducible pain occurred each time he walked 50 yards and resolved upon sitting down. He denied tissue loss or rest pain. His past medical history was significant for hypertension, hypercholesterolemia and tobacco use, as well as coronary revascularization.
On physical examination, he had bilateral carotid bruits, normal heart examination, and a strong right femoral pulse, but absent popliteal and pedal pulses. His left lower extremity had a saphenectomy scar. Both extremities had shiny, hairless skin without ulcerations or gangrene.
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