Which symptom is commonly associated with peripheral vascular disease in a patient who smokes?

Intermittent claudication is a symptom frequently seen in patients with peripheral vascular disease (PVD), particularly among those who smoke. It refers to muscle pain, typically in the legs or buttocks, that occurs during physical activity such as walking and is relieved by rest. This symptom arises due to inadequate blood flow to the muscles, often caused by atherosclerosis, which is more prevalent in individuals with a history of smoking. Smoking contributes to the development and progression of vascular disease by promoting plaque formation and narrowing of the arteries, thereby diminishing blood supply during exertion.

The other symptoms mentioned, while they may arise from different underlying conditions, are less characteristic of peripheral vascular disease linked to smoking. Chest pressure with exertion is more associated with coronary artery disease, leg swelling can indicate venous insufficiency or heart failure, and dizziness upon standing is often related to orthostatic hypotension or autonomic dysfunction rather than peripheral artery problems specifically related to PVD. Thus, intermittent claudication is the most indicative symptom of PVD in smokers.