Chronic mesenteric ischemia: role of the nurse practitioner in diagnosis and management.

Mesenteric ischemia can be a very subtle chronic disease state that may be hard to diagnose. The early symptoms are mild and may be mistaken for other disease entities in the elderly patient with multiple medical problems. Mesenteric ischemia can be fatal secondary to complications such as malnutrition, infection, and compounded comorbid conditions. The risk factors for this problem are the same as for any vascular disease: advanced age, hypertension, smoking, hyperlipidemia, and diabetes. Because of the subtle nature of symptoms, diagnosis may be delayed. The practitioner must be vigilant in evaluating patients at risk and refer these patients to the appropriate vascular specialist.