A 67-year-old man with hypertension controlled on lisinopril presents with bilateral calf claudication after walking two blocks, relieved by rest. Vital signs show BP 158/92 mmHg, HR 88/min, RR 16/min. Physical examination reveals diminished dorsalis pedis pulses bilaterally and shiny, hairless skin over both shins. Ankle-brachial index is 0.62 on the right. Cardiac examination shows no murmurs or gallops. Which of the following is the most likely diagnosis?
- A)Syphilitic thoracic aortic aneurysm
- B)Abdominal aortic aneurysm
- C)Thromboangiitis obliterans
- D)Aortic dissection
- E)Peripheral arterial diseaseGABARITO
Explicação
Peripheral arterial disease is correct. Exertional calf pain relieved by rest is intermittent claudication caused by fixed atherosclerotic narrowing of lower extremity arteries. Reduced distal pulses and trophic skin changes support chronic limb ischemia from ... Ver explicação completa e trilha adaptativa →