Lower extremity peripheral artery disease (PAD) effects >230 million adults worldwide and is associated with increased risk of various adverse clinical outcomes, including coronary artery disease, myocardial infarction, congestive heart failure, stroke, and amputation.

This 69-year old patient presented with leg claudication, which is a type of leg muscle pain that occurs due to lack of oxygen, and that’s triggered by activity and relieved by rest. Claudication is most often a symptom of peripheral artery disease.

The patient’s vascular surgeon obtained a cardiology screening evaluation which led to a positive stress test and cardiac catheterization that showed life-threatening left main and three- vessel coronary artery disease —with no history of angina, diabetes, or MI! His only risk factors were PAD and smoking.

The patient underwent triple vessel coronary artery bypass surgery with bilateral internal mammary artery grafts. He is going home on postoperative day #4 and will follow-up with his vascular surgeon for the leg bypass surgery within the next 6 weeks.