Patient: [Patient Name]
MRN: [Medical Record Number]
Date: [Date of Encounter]
Chief Complaint:
New or follow-up for mesenteric artery aneurysm (MAA)
(Specify) Abdominal pain (vague, postprandial – after meals, chronic, or acute)
May mention nausea, vomiting, weight loss, or signs of intestinal ischemia (gangrene) in severe cases
History of Present Illness:
For new patients:
Character, location, duration, and severity of abdominal pain.
Any aggravating or alleviating factors (e.g., relation to meals).
Associated symptoms (nausea, vomiting, weight loss).
Risk factors for MAA (atherosclerosis, smoking, hypertension).
For established MAA:
Follow-up since diagnosis and treatment.
Any changes in abdominal pain or other symptoms.
Treatment side effects or complications.
Past Medical History:
Atherosclerosis and its risk factors (hypertension, hyperlipidemia, diabetes mellitus, smoking)
Previous abdominal surgeries
Peripheral artery disease (PAD)
Medications:
List all current medications, including medications for cardiovascular health (antiplatelets, statins, antihypertensives).
Social History:
Smoking history (major risk factor).
Dietary habits.
Family History:
Family history of atherosclerosis or aneurysms.
Physical Exam:
Abdominal examination:
Assess for abdominal tenderness, pulsatile mass, or bruit (abnormal sound) over the aorta.
Check for signs of intestinal ischemia (distention, tenderness, guarding).
General examination: Evaluate for signs of atherosclerosis (e.g., bruits in carotid arteries).
Laboratory Tests:
Complete blood count (CBC) to rule out anemia or signs of infection.
Basic metabolic panel to assess electrolytes, kidney function, and diabetes control.
Lipoprotein panel to assess cholesterol levels.
Imaging Studies (as indicated):
Abdominal ultrasound: Initial imaging study to screen for MAA, may reveal a dilated artery.
CTA (computed tomography angiography) or MRA (magnetic resonance angiography): Definitive diagnostic tests for MAA, providing detailed images of the aorta and mesenteric arteries.
Angiography (traditional catheter angiography): May be used in specific cases for complex anatomy or prior to certain endovascular procedures.
Assessment:
Mesenteric artery aneurysm: Based on clinical suspicion, imaging findings (if available), and consideration of alternative diagnoses, suspect or confirm MAA.
Aneurysm size and location: Describe the size and location of the aneurysm to guide treatment decisions.
Symptoms and risk of complications: Evaluate the presence of symptoms and the risk of complications (rupture, thrombosis – blood clot formation within the aneurysm).
Plan:
Treatment (depends on aneurysm size, symptoms, and patient factors):
Observation: For small asymptomatic aneurysms with low rupture risk, regular surveillance with imaging studies may be recommended.
Endovascular repair (EVAR): Minimally invasive procedure using a stent graft to exclude the aneurysm from blood flow. Preferred approach for many suitable patients.
Open surgical repair: Traditional surgery involving removal of the aneurysm and graft replacement of the affected artery segment. May be necessary for large, symptomatic, or anatomically complex aneurysms.
Medical management: Optimize cardiovascular risk factors with medications (antiplatelets, statins, antihypertensives) to reduce the risk of progression and complications.
Vascular consultation: Referral to a vascular surgeon for definitive diagnosis, treatment planning, and potential intervention.
Follow-up: Schedule regular follow-up visits with imaging studies (depending on treatment plan) to monitor aneurysm size and potential complications.
Education:
Educate the patient about MAA, symptoms, risk factors, treatment options, and potential complications.
Discuss the importance of lifestyle modifications (smoking cessation, healthy diet) to improve cardiovascular health and reduce the risk of progression.
Provide resources for patient advocacy organizations specializing in vascular disease.
Disclaimer: This template is for informational purposes only and should be adapted to the specific needs of each patient. Mesenteric artery aneurysms are serious conditions that require prompt diagnosis and management to prevent life-threatening complications like rupture. Early intervention can significantly improve patient outcomes.