Mesenteric Angina

The main cause of mesenteric angina is atherosclerosis, the same condition that leads to heart disease.

Plaque buildup narrows the mesenteric arteries, reducing blood flow.
Other potential causes include:

• Blood clots: These can suddenly block blood flow in a mesenteric artery.
• Low blood pressure: Can exacerbate reduced blood flow to the intestines.
• Arterial abnormalities: Congenital or acquired defects can lead to blockages.

Fact: Although fairly rare, chronic mesenteric ischemia is often underdiagnosed due to its non-specific symptoms.*1

Mesenteric angina symptoms are often vague, leading to delays in diagnosis. Common signs include:

Abdominal pain: A dull, cramping pain that worsens after eating.
Weight loss: Patients may avoid eating due to fear of pain, leading to unintentional weight loss.
Nausea or vomiting: Especially after meals.
Diarrhea: May occur in some cases.

Did You Know? In its early stages, mesenteric angina is sometimes misdiagnosed as other gastrointestinal disorders, such as irritable bowel syndrome (IBS).*2

Certain groups are more prone to developing mesenteric angina:

• People over 60 years old: Age-related arterial stiffening increases the risk.
• Smokers: Smoking accelerates plaque buildup in arteries.
• Patients with diabetes: Diabetes damages blood vessels over time.
• Individuals with high cholesterol or hypertension: Both contribute to atherosclerosis.

Insight: A combination of risk factors such as smoking and diabetes significantly increases the likelihood of developing mesenteric ischemia, according to vascular studies.*3

Diagnosing mesenteric angina requires a thorough medical history and advanced imaging techniques:

• Doppler Ultrasound: A non-invasive test that measures blood flow in the mesenteric arteries.
• CT Angiography (CTA): Provides detailed images of the arteries, often considered the gold standard for diagnosis.
• MRI: Useful for patients who cannot undergo a CT scan.
• Endoscopy: Sometimes used to rule out other conditions causing similar symptoms.

Accessible Diagnostics: Comprehensive bulk-billed imaging for arterial vascular conditions is available at clinics in Gregory Hills, Wollongong, and Orange.Our new scanner is DETAILS HERE.

Treatment depends on the severity of the condition and the underlying cause. Options include:

Lifestyle Changes

• Quit smoking to slow the progression of arterial disease.
• Adopt a heart-healthy diet low in saturated fats and high in fiber.
• Control blood pressure, cholesterol, and blood sugar levels.

Medications

• Antiplatelet drugs: Prevent blood clots in narrowed arteries.
• Statins: Lower cholesterol and stabilize arterial plaques.
• Blood pressure medications: Protect arteries by reducing stress on their walls.

Surgical Interventions

• Angioplasty and Stenting: A minimally invasive procedure where a balloon is used to widen the artery, followed by placing a stent to keep it open.
• Bypass Surgery: Creates an alternate route for blood flow around the blocked artery.
• Endarterectomy: Removes plaque directly from the artery.

Outcomes: The success rate of angioplasty with stenting for restoring blood flow in coronary arteries is above 90%, making it an effective treatment for relieving symptoms such as chest pain (angina) and reducing the risk of heart attacks.*4

Innovative treatments are improving outcomes for patients:

• Drug-eluting stents: These stents release medication to prevent re-narrowing of the artery, improving long-term success rates.
• Hybrid procedures: Combining minimally-invasive techniques with open surgery for complex cases.
• Artificial Intelligence (AI): AI-driven imaging is helping doctors detect mesenteric artery blockages earlier, leading to faster interventions.

Did you know? AI-driven analysis is being evaluated for non-occlusive mesenteric ischemia (NOMI), where machine learning models help identify early-stage cases that might otherwise go undetected.*5

Without treatment, mesenteric angina can progress to acute mesenteric ischemia, a medical emergency that can cause permanent intestinal damage or death. Early diagnosis and treatment are critical to preventing complications.
Untreated acute mesenteric ischemia has a mortality rate of 60–80%, but timely intervention reduces this to 20% or less.*6

Protect Your Digestive Health: If you experience persistent abdominal pain after meals, don’t ignore it. Early detection can save your life.

Schedule Your Consultation: Advanced diagnostic imaging and treatment options for mesenteric angina are available at Gregory Hills, Wollongong, and Orange. Contact AVC on 02 4226 9333.

Sources:

1. Chronic mesenteric ischemia: Diagnosis & management｜PMC
2. Mesenteric ischemia｜Mayo Clinic
3. Intestinal ischemia | Mayo Clinic
4. Coronary angioplasty and stents (PCI)｜BHF
5. Non-occlusive mesenteric ischemia: Diagnostic challenges and perspectives in the era of artificial intelligence｜PMC
6. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery｜PubMed