In this case-control study, CECS patients ≥50 years were selected from a prospectively followed cohort and compared with a sample of newly diagnosed PAD patients ≥50 years. A questionnaire assessed frequency and severity of lower limb pain, tightness, cramps, muscle weakness and altered skin sensation at rest and exercise.
At rest, CECS patients (n=43, 42% female, 57 years, range 50-76) reported significantly more pain, tightness, muscle weakness and altered lower limb skin sensation (all p<0.01) than PAD patients (n=41, 39% female, 72 years, range 51-93). Having CECS was associated with a significantly higher combined symptom score at rest (p=0.02). During exercise, CECS patients experienced more tightness, muscle weakness and altered sensation (p<0.01) but not pain and cramps (p=0.36, p=0.70). Exercise induced complaints occurred much later in CECS patients than in PAD patients (15 vs 4 minutes, p<0.01). Persistence of pain over 4.5 minutes proved most discriminative for the presence of CECS (sensitivity 95%, specificity 54%, PPV 65%). Exercise cessation completely alleviated complaints in all PAD patients (n=41) but not in 73% (n=29) of the CECS patients. Ongoing discomfort strongly predicted the presence of CECS (sensitivity 73%, specificity 100%, PPV 100%).
CECS patients ≥50 years report a symptom pattern that is different from patients with PAD. These differences may aid vascular surgeons in identifying older patients with CECS.
Copyright © 2020. Published by Elsevier Inc.