VASCULAR SURGERY CASE1:
HPI:  59 y.o. AA male with a history of DM, HTN and a back surgery in 1999 presents today with pain primarily in the Left hip that radiates down his leg, occurs only after exertion (walking perhaps a block), has been occuring since his back surgery in 1999, and goes away with rest.  Patient denies any non-healing sores/lesions on either feet.  ABI from 2 months back revealed that decreased lower extremity pulses (ABI of .72 in right leg and .52 in left leg).   His diabetes and htn are well managed with medication and diet.  He smokes a pipe regularly.  PE did not reveal any lesions in the extremities and was essentially normal with the exception of decreased lower extremity peripheral pulses (hardly palpable or not palpable) but doplarable in both lower extremities.

A/P:  59 y.o. AA male with a history of DM, HTN presenting with Peripheral arterial disease.  We recommend conservative treatment:  continue diet, current medications and aspririn, exercise, cessation of smoking, and an ultrasound followup in a few months.  His symptoms are not severe enough to warrant any type of vascular surgery.