590 The Value of Peripheral Pulse Examination in the Diagnosis of Intermittent Claudication

Abstract

Abstract Aim The primary aim was to objectively evaluate the use of peripheral pulse examination as a screening tool for IC by calculating the sensitivity and specificity. Our secondary aim was to describe the cohort of patients referred to the clinic by their GP and identify areas for improvement and early initiation of best medical therapy. Method This study used a retrospective analysis of a prospectively maintained database. Records of all patients referred to the claudication clinic were collected from October 2018 to October 2019. The most distal palpable pulse of each leg was assigned a value and combined to create a ‘peripheral pulse score’. Risk factors, ABPI results, Peripheral Artery Disease (PAD) status and details of ongoing medical therapy were also recorded. Results 211 patients referred by their GP were included in the study. The absence of bilateral foot pulses was found to have a sensitivity of 86%, specificity 92%, PPV 95% and NPV 79%. There is a strong correlation between peripheral pulse score and ABPI. Only 27% of patients suspected of having IC by their GP were on best medical therapy at their initial clinic visit. Conclusions Peripheral pulse examination is a valuable diagnostic tool for identifying patients with IC and can be used to guide referral to specialist services. We provide evidence for the use of foot pulses as a screening tool to be used by primary care providers. More patients being referred to the IC clinic can be started on best medical therapy for secondary prevention at the time of referral.