Q: Which cardiac medicine may lead to mesenteric ischemia?A: Digitalis 1.
Digitalis has been found to cause vasoconstriction of both arterial and venous smooth muscle cells in the mesenteric vasculature. Acute intestinal ischemia could be the most deceiving clinical condition and requires very high index of suspicion. Acute mesenteric ischemia is a deadly disease, difficult to diagnose in timely fashion and delayed intervention resulting mostly in fatal outcome.
Clinical Findings: There generally are minimal clinical, laboratory and radiologic findings. Fever, abdominal pain which may be severe, nausea, vomiting. Although non specific, marked increase in serum lactate is common.
Causes: Acute Occlusion of Superior mesenteric artery, atherosclerosis, thrombosis, venous thrombosis.
Treatment: Early diagnosis and resection of dead bowel. Generally diagnosed at Laparotomy.
Prognosis: Rapidly leads to Multi Organ Dysfunction Syndrome with very high mortality rate.
Reference: click to get abstract
1. Nonocclusive mesenteric ischemia induced by digitalis - International Journal of Colorectal Disease, Volume 19, Number 3, May 2004, pp. 277-280(4)
