Case History/ Examination
A 30-year female weighing 59 kg presented three months back with a
4-year history of easy fatigue in the bilateral upper limbs, initially
triggered by strenuous activity. She was diagnosed anemia with
multivitamin deficiency and managed accordingly. However, fatigue
progressively worsened over the last seven days and is now present even
on general activities. Recently, she also experienced limb claudication,
jaw claudication while eating, bilateral temporal headaches with orbital
pain, and painful intermittent blurred vision, which worsened in the
last three days. Additionally, she reported dizziness and
lightheadedness for the past three days.
On examination, her systolic blood pressure was 60 mmHg with an
unrecordable diastolic pressure, respiratory rate was 24 breaths per
minute, pulse was 97 beats per minute(bpm), temperature was 97°F, and
oxygen saturation was 98% on room air. She had a Glasgow Coma Scale
(GCS) score of 15/15, and her random blood sugar was 150 mg/dL. Physical
examination revealed pallor in the bilateral palpebral conjunctiva, a
feeble pulse in the right radial artery with no pulse in the left radial
artery, palpable bilateral dorsalis pedis, a bruit over the right
carotid artery, and absent bruit over the left. Systemic examinations
were otherwise normal. There was no similar history in the family.