Acute Bilateral Lower Limb Ischemia in a Middle-Aged Woman: Don't Let the Obvious Distract You From the Occult.

Acute bilateral lower limb ischemia is a rare and life-threatening vascular emergency. Atypical presentations may lead to misdiagnosis, particularly when behavioral disturbances dominate the clinical picture. This report discusses a case of a 40-year-old South-Asian female who presented with severe bilateral lower limb pain and agitation, initially suspected to be psychiatric in origin. Further assessment revealed that the patient is suffering from acute bilateral lower limb ischemia. This case highlights the importance of thorough physical examination, maintaining a broad differential diagnosis, and early use of diagnostic imaging in atypical presentations of acute limb ischemia.