High prevalence of coronary heart disease in patients with intermittent claudication. A preliminary report

Twenty-five men aged 53-70 years, with stable intermittent claudication and similar symptoms and walking distance, were investigated with myocardial scintigraphy, duplex ultrasonography of carotid arteries and femoral angiography. Each patient was scored according to the degree of stenosis in the popliteal trifurcation and the aortoiliac and carotid arteries. Eighteen of the 25 men had coronary heart disease, which was clinically evident in nine cases and scintigraphically demonstrated in 17/24. Ischemia or infarction without clinical manifestation was located in the atrio-ventricular septal region in all nine cases. Eight of the 25 patients were shown to have carotid lesions. Significant correlation was found between lesions in the trifurcation and in the carotid arteries, but not between aortoiliac and carotid lesions. Trifurcational disease was a somewhat weaker marker for coronary heart disease. The high prevalence of coronary heart disease is noteworthy, especially the septal pathology, and further studies on the clinical significance of the findings appear to be urgently required.