Which of the following is/are true regarding exercise testing and reactive hyperemia in patients with peripheral vascular occlusive disease?
- Normal individuals walk on a treadmill at 2 m.p.h. at a 10% grade without experiencing leg pain and ankle pressure remains unchanged after exercise
- In patients with arterial obstruction, pain usually forces cessation of walking after 2–3 minutes and the ankle pressure measured immediately after exercise is diminished
- The time required for pressure to return to baseline is usually 2–3 minutes
- Reactive hyperemia may be used as a substitute for treadmill exercise
Medicine
a. Normal individuals walk on a treadmill at 2 m.p.h. at a 10% grade without experiencing leg pain and ankle pressure remains unchanged after exercise
b. In patients with arterial obstruction, pain usually forces cessation of walking after 2–3 minutes and the ankle pressure measured immediately after exercise is diminished
d. Reactive hyperemia may be used as a substitute for treadmill exercise
Normal subjects walk without pain and do not drop their ankle pressure after exercise. In patients with arterial obstruction there is a drop in ankle pressure after exercise and the severity of that drop is roughly proportional to the severity of the occlusive process. Likewise the time for pressure to return to pre-exercise levels is proportional to the severity of the occlusive process and may exceed 20 minutes in severely diseased extremities. The reactive hyperemia test is quite sensitive in patients who cannot exercise, and may be used as a substitute for treadmill exercise.
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