A 50-year-old man has a history of heart disease and presents with intermittent claudication. Which test would be most appropriate in assessing his vascular status?

The Ankle-Brachial Index (ABI) is a key diagnostic test for assessing peripheral arterial disease (PAD), which is particularly pertinent for a patient with a history of heart disease presenting with intermittent claudication. The ABI measures the ratio of the blood pressure in the patient’s ankle to the blood pressure in the arm. By comparing these two readings, it helps to determine if there is reduced blood flow to the legs caused by peripheral artery obstruction.

A low ABI value indicates narrowed or blocked arteries, which is a common cause of intermittent claudication in patients with cardiovascular disease. The simplicity, cost-effectiveness, and non-invasive nature of this test make it the preferred initial assessment tool in many clinical settings when evaluating symptoms suggestive of PAD. Furthermore, the ABI is widely accepted and validated in clinical practice for assessing the severity of vascular compromise in the limbs.

In contrast, while other imaging options like arterial Doppler ultrasound, MRI angiography, and CT angiography can provide detailed information about vascular anatomy and blood flow, they are typically used in more complex cases or when further anatomical information is necessary following an initial examination. The ABI serves as an effective first-line tool for evaluating a patient like the one described.