Myocardial ischemia
DEFINITION
Myocardial ischemia occurs when blood flow to your heart muscle is decreased by a partial or complete blockage of your heart’s arteries (coronary arteries). The decrease in blood flow reduces your heart’s oxygen supply.
Myocardial ischemia, also called cardiac ischemia, can damage your heart muscle, reducing its ability to pump efficiently. A sudden, severe blockage of a coronary artery may lead to a heart attack. Myocardial ischemia may also cause serious abnormal heart rhythms.
Treatment for myocardial ischemia is directed at improving blood flow to the heart muscle and may include medications, a procedure to open blocked arteries or coronary artery bypass surgery. Making heart-healthy lifestyle choices is important in treating and preventing myocardial ischemia.
CAUSES
Myocardial ischemia occurs when the blood flow through one or more of the blood vessels that lead to your heart (coronary arteries) is decreased. This decrease in blood flow leads to a decrease in the amount of oxygen your heart muscle (myocardium) receives. Myocardial ischemia may occur slowly as arteries become blocked over time, or it may occur quickly when an artery becomes blocked suddenly.
Conditions that may cause myocardial ischemia include:
- Coronary artery disease (atherosclerosis). Atherosclerosis occurs when plaques made of cholesterol and waste products build up on your artery walls and restrict blood flow. Atherosclerosis of the heart arteries is called coronary artery disease and is the most common cause of myocardial ischemia.
- Blood clot. The plaques that develop in atherosclerosis can rupture, causing a blood clot, which may lead to sudden, severe myocardial ischemia, resulting in a heart attack.
- Coronary artery spasm. A coronary artery spasm is a brief, temporary tightening (contraction) of the muscles in the artery wall. This can narrow and briefly decrease or even prevent blood flow to part of the heart muscle.
Things that may trigger chest pain associated with myocardial ischemia include:
- Physical exertion
- Emotional stress
- Cold temperatures
- Lying down
- Cocaine use
SYMPTOMS
Some people who have myocardial ischemia don’t experience any signs or symptoms (silent ischemia). When myocardial ischemia does cause signs and symptoms, they may include:
- Chest pressure or pain, typically on the left side of the body (angina pectoris)
- Neck or jaw pain
- Shoulder or arm pain
- A fast heartbeat
- Shortness of breath
- Nausea and vomiting
When to see a doctor
If you have chest discomfort, especially if it’s accompanied by one or more of the other signs and symptoms listed above, seek medical care immediately. Call 911 or your local emergency number. If you don’t have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options. Driving yourself puts you and others at risk if your condition suddenly worsens.
