Mesenteric Ischemia

by Carlo Raj, MD

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    Let us now move in to greater detail about Mesenteric Ischemia. This is Acute mesenteric ischemia, absolute emergency. The patient walks in or you get a clinical vignette and you've been given an ECG. On your ECG, take a look at your P waves, or at least you try to identify them and you can't, they're absent or they're wave like. And you notice that the heart rate is approximately 250 beats per minute. Patient here maybe approximately 65 years of age, so elderly. At this point, you're worried about the left atrium undergoing atrial fibrillation. And with this turbulence that's taking place with the left atrium then this is part of your Virchow's triad, meaning to say that it is not prone to thrombotic formation. A thrombosis that's not developed in the left atrium become very dangerous because you're worried about breaking off the thrombi and embolization distally. Now I will tell you that the embolization and the most important of embolization over the most destructive but not the most common site of embolization, so a couple of things here. When we talk about cerebrovascular accident and stroke, when you have embolization from atrial fibrillation of your thrombi from the left atrium, what you're worried about and why you've given this patient prophylactic Warfarin it is so that you will prevent; now to this day clinically it's been proven, evidence–based, that Warfarin is the drug of choice to prevent cerebrovascular accidents as a result of embolization of a thrombus in left atrium secondary to atrial fibrillation. You got all that? Now in terms of embolization, it is not the carotid artery in which it is the number one site. It may end up in the renal artery with embolization or as our topic here brings us to SMA, which...

    About the Lecture

    The lecture Mesenteric Ischemia by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

    Author of lecture Mesenteric Ischemia

     Carlo Raj, MD

    Carlo Raj, MD

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