Although in his mid-70s, a man enjoyed doing the gardens of his „elderly’ neighbors, but he’d found it difficult this winter.
“ After 10 minutes of digging I get cramp in my left calf, doctor. It goes off when I stop, but comes on very quickly again when I start digging again.”
“ Do you get it when you’re walking on the flat?” asked the doctor.
“ Not really, I can go half a mile easily, if I take it steady.”
“ Have you had any cramps in the other leg and do you get any pain in the chest when you’re gardening?” asked the doctor.
“ No doctor, I’m as fit as a fiddle except for this.”
“ No dizzy do’s or black outs? You’ve never smoked have you?” asked the doctor.
“ Not since I was about 8 doctor! And I’ve never had a dizzy do in my life.”
“ I‟ll have a look at you, then I’ll tell what’s to be done” said the doctor.
• What is the underlying problem and what is this pattern of symptoms called?
• At which sites in the arterial system could the problem causing this man’s symptoms be located?
• What other tissue in his limb could be affected and how would it be manifested?
• Which arterial pulses would the doctor need to record?
• Which two metabolic anomalies could be important in this case?
