What is the most likely cause of leg pain relieved by rest in an 83-year-old man with a history of myocardial infarction?

The most likely cause of leg pain that is relieved by rest in an 83-year-old man with a history of myocardial infarction is peripheral arterial disease (PAD). This condition occurs due to the narrowing or blockage of the arteries, often caused by atherosclerosis, leading to reduced blood flow to the limbs. In older adults, especially those with cardiovascular issues, such as a history of myocardial infarction, the risk of developing PAD is elevated.

Patients with peripheral arterial disease commonly experience claudication, which is characterized by muscle pain or cramping in the legs during physical activity—such as walking—but is relieved by rest. This pattern is particularly indicative of ischemic pain due to inadequate blood supply during exertion.

In contrast, while osteoarthritis can cause joint pain and stiffness, it does not typically present with a pattern of pain that is relieved specifically by rest, as the discomfort can persist even when not active. Peripheral polyneuropathy often presents with pain that is more burning or tingling in nature and is generally not relieved by rest; it usually affects both legs symmetrically. Spinal stenosis may cause leg pain, but this pain is usually exacerbated by standing and walking and improved by bending forward or sitting rather than complete rest.