Characterization of the peripheral artery disease symptom experience

Abstract

Claudication is the most commonly recognized peripheral artery disease (PAD) symptom, but not the most prevalent. Only 7.5% to 33% of patients report claudication as being part of their symptom experience. However, there is little evidence supporting atypical symptom reporting. The study purpose was to describe the full spectrum of symptoms experienced by older and younger individuals with PAD. Semistructured interviews were conducted with a purposive sample of 38 commmunity-dwelling adults aged 49 to 83 years; transcripts were analyzed using content analysis. Six themes emerged: symptom descriptors (claudication and atypical), maintaining equilibrium, temporal fluctuations, the role of exercise, perceived impact on quality of life, and disease presence and treatment. Results suggest heavy reliance on claudication can result in mis- or under-diagnosis of PAD. Further research is needed to validate the correspondence of atypical symptoms with ischemic changes during exercise to broaden currently accepted symptom locations and descriptors associated with PAD.

Living a burdensome and demanding life: A qualitative systematic review of the patients experiences of peripheral arterial disease

“…Two were conducted in the USA and one in the Netherlands ( Table 1 ). Where reported, interview setting ranged from patients’ homes[ 10 – 12 , 14 – 16 , 20 , 21 ], researcher’s workplace[ 16 ], to facilities outside[ 18 ] or within the hospital[ 11 – 13 , 19 ] or university[ 10 ]. All participants in included studies were stated to have been diagnosed with PAD, but majority of the studies[ 12 , 14 – 16 , 18 – 22 ] did not report diagnostic criteria.…”

“…Five studies[ 12 , 18 – 21 ] included participants at various stages of the disease: intermittent claudication(IC), chronic limb ischaemic (CLI), and ischemic ulcer). The remaining studies[ 10 , 11 , 13 , 16 , 17 , 22 , 23 ] included only patients with symptoms of IC. There were similar variations within and across included studies about the type of treatment participants were undergoing.…”

“…Seven studies[ 10 , 11 , 15 , 18 – 21 ] were awarded nine out of a possible 10 ‘yes’ responses; five studies[ 14 , 16 , 17 , 22 ] were awarded eight ‘yes’ responses. One study each was awarded 10[ 13 ], six[ 23 ], and five[ 12 ] ‘yes’ responses. The main source or potential source of bias in included studies was uncertainty about the role of the researcher, or any attempt to counter potential researcher bias on data collection (n = 12).…”

“…Symptom progression saw the pain and discomfort began to wear the patients down[ 11 , 15 , 16 , 18 ], often bringing embarrassment when they had to stop in the middle of the road to let the pain go away[ 10 , 11 , 16 , 17 ]. In addition to walking impairment, patients reported impairment in other aspects of physical functioning, feeling restricted and a loss of independence[ 12 , 14 – 17 , 20 ], which had a major impact on several aspects of their quality of life[ 11 – 13 , 15 , 18 ] including pleasure[ 16 ], social life[ 12 , 20 ], recreation[ 16 ], and sleep quality[ 20 ] for those with rest pain. Patients interpreted this as a sense of burden, powerlessness, isolation, and compromised independence: “Yes, it’s just like it has taken the strength and power from me…, you have to do this and that but you can’t … You have to give up”[ 20 ].…”

The Relationship Between Peripheral Artery Disease Symptomatology and Ischemia

“…In addition to completing the treadmill testing, participants were interviewed about their symptom experiences (see Schorr, Peden-McAlpine, Treat-Jacobson, & Lindquist, 2015). During treadmill testing, calf tissue oxygenation via near-infrared spectroscopy (NIRS) and patient report of symptom intensity were obtained simultaneously.…”