Abdominal angina (patient information)
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What is abdominal angina?
How do I know if I have abdominal angina and what are the symptoms of abdominal angina?
- Abdominal pain: The classic pain is located in midepigastric or central, develops 10-15 minutes after eating. Some pain may described as cramplike or a dull ache and be poorly localized.
- Diarrhea or constipation
- Bloating
- Vomiting
Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.
Who is at risk for abdominal angina?
Abdominal angina is extremely rare, and epidemiological studies show it may be associated with the following factors.
- Smoking: Clinical data show that approximately 75-80% of patients smoke.
- Age: Age older than 60 years increases the risk of getting abdominal angina.
- Sex: Females outnumber males by approximately 3 to 1.
- Race: No data demonatrates the relationship between race and the incidence of abdominal angina.
How to know you have abdominal angina?
Imaging studies are needed to identify the diagnosis.
- Biplane aortography: It is the criterion standard test for the diagnosis of abdominal angina. Because the vessels emerge from the anterior wall of the aorta, the ostia are visualized only on a lateral view. A lateral aortogram shows abrupt cutoffs at the origin of the visceral vessels and a tapered occlusion of the distal aorta. Because these vessels originate from the anterior surface of the aorta, stenoses and occlusions are not observed clearly on standard anteroposterior views. A meandering mesenteric artery, shown below, is another clue. In addition to demonstrating the level of stenosis or occlusion of the mesenteric vessels, angiography findings also help plan the operative approach by delineating the anatomy of the supraceliac and infrarenal abdominal aorta.
This arteriogram illustrates a meandering mesenteric artery. The appearance of a meandering mesenteric artery such as this one supports the diagnosis of chronic mesenteric ischemia.Hydrating the patient well before angiography is extremely important, not only to avoid renal toxicity but also because visceral infarction may be precipitated by the injection of contrast. Duplex ultrasonographic examination is emerging as a useful screening modality. It currently is most useful in patients in whom the diagnosis is suspected. If the duplex examination is positive, angiography is performed.2,3 Indices that are studied include the following: Peak systolic flow is increased if a stenosis is present. When an increase is expected, a change in flow velocities occurs in response to feeding, unless a flow-limiting stenosis is present. Perform a spectral analysis of Doppler frequencies.
- MRI: Magnetic resonance angiography has been used as an alternative to aortography in patients who have contrast sensitivity or who are at risk for contrast-related renal dysfunction. It is emerging as an excellent diagnostic modality due to its ability to delineate the anatomy. It also is a useful experimental tool for studying metabolic parameters.
When to seek urgent medical care?
Treatment options
Diseases with similar symptoms
- Gastrointestinal cancer, such as stomach cancer, gallbladder cancer or colorectal cancer.
Where to find medical care for abdominal angina?
Directions to Hospitals Treating abdominal angina
Prevention of abdominal angina
What to expect (Outlook/Prognosis)?
Sources
http://emedicine.medscape.com/article/188618-overview
http://askdrwiki.com/mediawiki/index.php?title=Abdominal_angina