Chronic Mesenteric Ischemia

Question 1

What condition is characterized by abdominal pain 1-2 hours after eating meals in patients with cardiovascular disease?

Answer 1

Chronic mesenteric ischemia

This condition arises due to decreased blood flow to the intestines, often caused by atherosclerosis.

Question 2

What causes chronic mesenteric ischemia?

Answer 2

Atherosclerosis of the SMA or IMA

SMA: Superior Mesenteric Artery, IMA: Inferior Mesenteric Artery.

Question 3

Why does eating trigger abdominal pain in chronic mesenteric ischemia?

Answer 3

Increased oxygen demand of the bowel leads to angina of the bowel.

Question 4

What is the typical patient profile for chronic mesenteric ischemia?

Answer 4

69-year-old male with a history of coronary artery bypass grafting, intermittent claudication, hypertension, and diabetes.

Question 5

What is the next best step in management for chronic mesenteric ischemia according to USMLE?

Answer 5

Mesenteric angiography.

Question 6

Fill in the blank: Chronic mesenteric ischemia can be confused with pain from _______.

Answer 6

duodenal ulcers.

• The timing of the pain in relation to meals sounds like duodenal ulcers, however instead of the vignette being a 29-year-old dude from Indonesia with H. pylori, it will be a 69-year-old dude with Hx of coronary artery bypass
  grafting, intermittent claudication, HTN, and diabetes.