6 Months Of Reproducible in Medicine / Internal Medicine — 64yo Man | Cardiology | SMLE Q#900
SMLE Question #900
Medicine / Internal Medicine
Cardiology
Last updated: February 2026
A 64-year-old man presents to the outpatient clinic with 6 months of reproducible right calf pain after walking about 300 meters that resolves within minutes of rest. He has a 40-pack-year smoking history and hypertension. He denies chest pain, dyspnea, or syncope. Examination shows diminished right dorsalis pedis and posterior tibial pulses compared with the left, with shiny, hairless skin over the shins. Cardiovascular examination is otherwise unremarkable, and a resting 12-lead ECG is normal. What is the most appropriate next diagnostic step to evaluate his symptoms?
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