Ischemia is a condition in which blood flow (and thus oxygen) is restricted or reduced in a part of the body. Cardiac ischemia is decreased blood flow and oxygen to the heart muscleIt’s heart problems caused by narrowed heart arteries. When arteries are narrowed, less blood and oxygen reach the heart muscle. This is also called coronary artery disease and coronary heart disease. This can lead to heart attack.Ischemia often causes chest pain or discomfort known as angina pectoris.Some heart attacks are sudden and intense but may start slowly, with mild pain or discomfort. There are some signs of a heart attack:Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain.Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.Shortness of breath. This may occur with or without chest discomfort.Other signs: These may include breaking out in a cold sweat, nausea, or light-headedness.As with men, women’s most common heart attack symptom is chest pain or discomfort. However women may experience other symptoms that are typically less associated with heart attack, such as shortness of breath, nausea/vomiting and back or jaw pain.
What is a Heart Attack?
A heart attack occurs when blood flow that brings oxygen-rich blood to the heart muscle is severely reduced or cut off. This is due to a buildup of fat, cholesterol, and other substances (plaque) that narrows coronary arteries. This process is called atherosclerosis. When plaque in a heart artery breaks open, a blood clot forms. The clot can block blood flow. When it completely stops blood flow to part of the heart muscle, that portion of muscle begins to die. Damage increases the longer an artery stays blocked. Once some of the heart muscle dies, permanent heart damage results. The amount of damage to the heart muscle depends on the size of the area supplied by the blocked artery and the time between injury and treatment. The blocked artery should be opened as soon as possible to reduce heart damage.
Causes
- Coronary artery disease (atherosclerosis). Plaques made up mostly of cholesterol build up on your artery walls and restrict blood flow. Atherosclerosis is the most common cause of myocardial ischemia.
- Blood clot. The plaques that develop in atherosclerosis can rupture, causing a blood clot. The clot might block an artery and lead to sudden, severe myocardial ischemia, resulting in a heart attack. Rarely, a blood clot might travel to the coronary artery from elsewhere in the body.
- Coronary artery spasm. This temporary tightening of the muscles in the artery wall can briefly decrease or even prevent blood flow to part of the heart muscle. Coronary artery spasm is an uncommon cause of myocardial ischemia.
Risk factors
Tobacco. Smoking and long-term exposure to second-hand smoke can damage the inside walls of arteries. Smoking causes the coronary arteries to spasm and may also increase the risk of blood clots.
Diabetes. Type 1 and type 2 diabetes are linked to an increased risk of myocardial ischemia, heart attack, and other heart problems.
High blood pressure. Over time, high blood pressure can accelerate atherosclerosis, resulting in damage to the coronary arteries.
High blood cholesterol level. Cholesterol is a major part of the deposits that can narrow your coronary arteries. A high level of “bad” (low-density lipoprotein, or LDL) cholesterol in your blood may be due to an inherited condition or a diet high in saturated fats and cholesterol.
High blood triglyceride level. Triglycerides, another type of blood fat, also may contribute to atherosclerosis.
Obesity. Obesity is associated with diabetes, high blood pressure, and high blood cholesterol levels.
Waist circumference. A waist measurement of more than 35 inches (89 centimeters) in women and 40 inches (102 cm) in men increases the risk of high blood pressure, diabetes, and heart disease.
Lack of physical activity. Not getting enough exercise contributes to obesity and is linked to higher cholesterol and triglyceride levels. People who get regular aerobic exercise have better heart health, which is associated with a lower risk of myocardial ischemia and heart attack. Exercise also reduces blood pressure.
A family history of cardiovascular disease
How common is myocardial ischemia?
What are the symptoms?
- Nitro-glycerinefor quick relief of angina.
- Beta-blockers.
- Calcium channel blockers.
- Thrombolytics (clot-busting drugs).
- Angioplasty and stent placement.
- Coronary artery bypass graft.
There are two types of angina:
- Stable angina, which usually stops soon after you rest or take medication to manage it.
- Unstable angina, which can happen at any time, even when you’re relaxed or sleeping. It may not go away when you take medication.
Other myocardial ischemia symptoms can also include:
- Pain or discomfort in your upper body, including your arms, left shoulder, back, neck, jaw, or stomach.
- Trouble breathing or feeling short of breath.
- Sweating or “cold sweat.”
- Feeling full, indigestion, or a choking feeling (may feel like heartburn).
- Nausea or vomiting.
- Feeling lightheaded, dizzy, very weak, or anxious.
- Fast or irregular heartbeat.
How is myocardial ischemia diagnosed?
Your provider may also do blood tests to check for:
- Proteins and enzymes that only show up in the blood when the heart muscle is damaged.
- Causes of ischemia.
- High cholesterol.
What medications/treatments are used?
Medicines or treatments for myocardial ischemia may include:
- Nitro-glycerinefor quick relief of angina.
- Beta-blockers.
- Calcium channel blockers.
- Thrombolytics (clot-busting drugs).
- Angioplastyand stent placement.
- Coronary artery bypass graft.
Complications/side effects of the treatment
- Infection
- Bleeding
- Kidney failure
- Stroke.
- Heart attack.
- Arrhythmia(abnormal heart rhythm).
How long does it take to recover from this treatment?
- After a coronary artery bypass graft, you’ll need to spend about a week in the hospital. After that, you’ll need six to 12 weeks to recover at home.
- After angioplasty or stent placement, you’ll probably spend the night in the hospital and go home the next day.
