The interview and physical examination provide information that directs the need for additional diagnostic testing and treatment of patients with vascular disease. Today’s noninvasive vascular testing and imaging technologies tend to divert attention from the importance of talking to and examining the patient. These diagnostic tests add valuable hemodynamic and anatomic data but do not replace the need for a careful history and physical examination as the first step in optimal patient care. Even in this era of specialized imaging, the adage that “the patient will tell you what’s wrong, if you’re willing to listen” remains true.

The initial history and physical examination serve several purposes. The process enables the clinician to establish a clinical impression

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