Q:

Which of the following is/are appropriate candidates for exercise testing?

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Which of the following is/are appropriate candidates for exercise testing?


  1. The patient with symptoms of intermittent claudication but normal resting ankle brachial indices
  2. The patient with rest pain, nonhealing ulcers or gangrene
  3. If the resting ankle pressure is below 30–40 mmHg
  4. The patient with blue toe syndrome and readily palpable pedal pulses

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a. The patient with symptoms of intermittent claudication but normal resting ankle brachial indices

When the patient’s presenting complaints are compatible with claudication and the ABI is normal or nearly so treadmill exercise is quite helpful in unmasking significant arterial occlusive disease. In patients with obvious rest pain, nonhealing ulcers or gangrene the diagnosis of significant peripheral vascular disease is obvious, likewise for the patient’s whose resting ankle blood pressure is below 30 or 40 mmHg. Finally, in patients with atheroemboli and palpable pedal pulses, toe brachial indices may be helpful but exercise testing is not. Search for the embologenic source is more appropriate.

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