What constitutes proper evaluation for the patient with intermittent claudication?

Intermittent claudication is a well-recognized clinical entity with characteristic complaints and findings. The patient describes exertional leg discomfort brought on by a short walk. Calf, thigh, or hip muscles may be involved. The pain subsides during a brief rest and the individual can walk again. Peripheral pulses are reduced or absent, but otherwise the leg seems quite normal. On the basis of these simple features, a physician can readily establish the diagnosis of arterial insufficiency which for all practical purposes is due to atherosclerosis. Atherosclerosis itself is a manifestation of aging with involvement that may appear localized. Yet the disease process is often generalized with coronary, cerebral, or hypertensive manifestations. What, then, constitutes a proper evaluation for the patient with intermit-