Rest Pain

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Rest Pain

(Critical ischaemia)

• Pain at rest

• distal worse

• Worse at night

• Relieved by making leg dependent (e.g. hanging out of bed at night)

Pathology

• decreased arterial flow due to decreased assistance of gravity

• physiologically decreased cardiac output at rest

• reactive dilatation of skin vessels to warmth (e.g. in bed)

Accompanying signs

• skin pallor

• trophic changes

• ischaemic ulceration

  • especially at pressure points

• gangrene

  • usually dry

• Positive Buerger's test

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