From Big Medical Encyclopedia

THE ALTERNATING LAMENESS - the symptom of acute ischemia at obliterating diseases of vessels which is periodically arising in actively functioning body in connection with insufficient (inadequate to loading) inflow of oxygenic blood. Item x. it is observed at ischemic diseases of the lower extremities. Nek-ry researchers carry an angina of exertion, the alternating ischemia of a brain, abdominal organs to phenomena of this sort.

Item x. it can be observed at atherosclerosis, an obliterating thromboangitis, nonspecific aorto-arteritis, a diabetic arteriopatiya, etc.

of P. x. time to stop is shown by one or both leg pains during walking reaching such intensity that the patient is forced to reduce rate of walking or on a nek-swarm. During this rest of pain disappear, and the patient can pass a certain distance again. At an obliterating thromboangitis of pain arise in foot and a shin, at the obliterating atherosclerosis affecting an aortobedrenny segment — in gastrocnemius muscles and muscles of a hip, at occlusion of a ventral aorta — in gluteuses and in muscles of lumbar area (the high alternating lameness). At P. x. note also a chill of extremities, paresthesias, muscular weakness and other signs ischemia (see).

On character of a symptom of P. x. it is possible to define a stage of ischemia of the lower extremities approximately: at the I stage of pain arise during the passing by the patient of distance of St. 500 m, at IIA of a stage — from 200 to 500 m, at IIB of a stage — to 200, at the III stage — to 25 m; at the IV stage there are constant pains and ulcer and necrotic changes of fabrics.

Treatment and the forecast at P. x. depend on character of the reason which pulled out it (see. Obliterating defeats of vessels of extremities ).

Bibliography: Bondarchuk A. V. Diseases of peripheral vessels, JI., 1969; Vishnevsky A. A., Krakow y N. I. and Zolotorevsky V. Ya. Obliterating diseases of arteries of extremities, M., 1972; Pokrovsky A. V. Clinical angiology, M., 1979; The Specialty surgery of heart troubles and vessels, under the editorship of V. I. Burakovsky and S. A. Kolesnikov, M., 1967.

A. V. Pokrovsky.