Abdominal angina

Abdominal angina
Classification and external resources
Specialty
ICD-10	K55
ICD-9-CM	557.1
Patient UK	Abdominal angina

Abdominal angina is abdominal pain after eating that occurs in individuals with ongoing poor blood supply to their small intestines known as chronic mesenteric ischemia. The term angina is used in reference to angina pectoris, a similar symptom due to obstruction of the coronary artery. The American Heritage Stedman's Medical Dictionary defines abdominal angina as "Intermittent abdominal pain, frequently occurring at a fixed time after eating, caused by inadequacy of the mesenteric circulation. Also called intestinal angina."

Pathophysiology

The pathophysiology is similar to that seen in angina pectoris and intermittent claudication. The most common cause of abdominal angina is atherosclerotic vascular disease, where the occlusive process commonly involves the ostia and the proximal few centimeters of the mesenteric vessels. It can be associated with:

• carcinoid

• aortic coarctation

• antiphospholipid syndrome

Frequency

• Internationally: Extremely rare. True incidence is unknown
• Race: No data available
• Sex: Females outnumber males by approximately 3 to 1
• Age: Mean age of affected individuals is slightly older than 60 years

Clinical

• Hallmark of condition: Disabling midepigastric or central abdominal pain within 10–15 minutes after eating.
• Physical examination: The abdomen typically is scaphoid and soft, even during an episode of pain. Patients present with stigmata of weight loss and signs of peripheral vascular disease, particularly aortoiliac occlusive disease, may be present.
• Causes: Smoking is an associated risk factor. In most series, approximately 75-80% of patients smoke.

Treatment

Stents have been used in the treatment of abdominal angina.

See also

• Abdominal pain
• Ischemic colitis