After palpating several peripheral pulse sites, a therapist notes a strong popliteal pulse but a weak dorsalis pedis pulse. Which exercise-related finding is most likely?

• A. Orthopnea
• B. Deep vein thrombophlebitis
• C. Venous thrombosis
• D. Intermittent claudication

Answer: (D)

A discrepancy between a strong proximal arterial pulse and a weak distal pulse points to arterial insufficiency in the leg. When the popliteal pulse is strong but the dorsalis pedis pulse is weak, blood flow to the foot is reduced downstream, which is typical of peripheral arterial disease affecting the leg arteries.

During exercise, the leg muscles demand more blood. If the arteries cannot increase flow adequately, the exercising muscle becomes ischemic, producing cramping or pain in the calf that is triggered by walking and relieved by rest—intermittent claudication. This pattern fits PAD-related ischemia.

Orthopnea would signal heart failure with fluid overload and dyspnea; venous thrombosis would present more with leg swelling, warmth, and tenderness rather than a pattern of diminished distal arterial pulses under exertion.