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Correct Answer: intermittent claudication.
the correct answer to the question regarding which lower extremity occlusive disease can increase the risk of further cardiac events in a 55-year-old female patient who has started rehabilitation after cardiac bypass surgery is intermittent claudication.
intermittent claudication is a condition that results from occlusive arterial disease, commonly known as peripheral artery disease (pad). it is characterized by pain and cramping in the lower extremities that typically occurs with exercise and is relieved by rest. the pain is due to insufficient blood flow to the muscles during exercise, reflecting underlying atherosclerosis, which is the buildup of fatty deposits inside the arteries.
the relevance of intermittent claudication in this patient scenario ties back to its association with systemic atherosclerosis. patients with intermittent claudication have a higher prevalence of concurrent cardiovascular diseases such as coronary artery disease (the same condition that likely necessitated her cardiac bypass surgery). therefore, the presence of intermittent claudication is an indicator of more extensive atherosclerotic disease, which can affect not only the peripheral arteries but also the coronary and cerebral arteries, increasing the risk of heart attacks and strokes.
studies have shown that patients with intermittent claudication have a significantly increased risk of cardiovascular events. they are about 2.5 times more likely to experience a cardiac event compared to individuals of a similar age without this condition. this elevated risk persists even when controlling for other common risk factors, such as hypertension, diabetes, and cholesterol levels.
for the patient in question, especially being overweight and having a dislike for exercise, managing intermittent claudication is crucial. lack of physical activity can exacerbate the progression of atherosclerosis, leading to worsening claudication and increasing the risk of cardiac events. a rehabilitation program focused on supervised exercise, along with medical management of atherosclerosis, is essential for improving her overall cardiovascular health and reducing the risk of future cardiac events.
in summary, intermittent claudication is a critical marker of systemic atherosclerotic disease and a predictor of increased cardiac risk. it is essential for such patients to be under careful monitoring and to adhere to a comprehensive management plan that includes lifestyle modifications, pharmacotherapy, and possibly revascularization procedures tailored to their specific health needs.
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