Diseases & Condition-Blood Flow Reduction to Heart (Myochardial ischemia)

Myocardial ischemia

 

Myocardial ischemia occurs when blood flow to your heart is reduced, preventing it from receiving enough oxygen. The reduced blood flow is usually the result of a partial or complete blockage of your heart's arteries (coronary arteries).
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 can lead to a heart attack. Myocardial ischemia might also cause serious abnormal heart rhythms.
Treatment for myocardial ischemia involves improving blood flow to the heart muscle. Treatment may include medications, a procedure to open blocked arteries or bypass surgery.
Making heart-healthy lifestyle choices is important in treating and preventing myocardial ischemia.

Symptoms (Myocardial ischemia)

Some people who have ischemia don't experience any signs or symptoms (silent ischemia).
When signs and symptoms occur, the most common is chest pressure or pain, typically on the left side of the body (angina pectoris). Other signs and symptoms — which might be experienced more commonly by women, older people and people with diabetes — include:

• Neck or jaw pain
• Shoulder or arm pain
• A fast heartbeat
• Shortness of breath when you are physically active
• Nausea and vomiting
• Sweating
• Fatigue

Causes (Myocardial ischemia)

Myocardial ischemia occurs when the blood flow through one or more of your coronary arteries is
decreased. The low blood flow decreases the amount of oxygen your heart muscle receives.
Myocardial ischemia can develop slowly as arteries become blocked over time. Or it can occur quickly when an artery becomes blocked suddenly.
Conditions that can cause myocardial ischemia include:

• 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.

Chest pain associated with myocardial ischemia can be triggered by:

• Physical exertion
• Emotional stress
• Cold temperatures
• Cocaine use

Treatments and drugs (Myocardial ischemia)

Treatment of myocardial ischemia is directed at improving blood flow to the heart muscle. Depending on the severity of your condition, you may be treated with medications, surgery or both.

Medications

Medications to treat myocardial ischemia include:

• Aspirin. A daily aspirin or other blood thinner can reduce your risk of blood clots, which might help prevent obstruction of your coronary arteries. Ask your doctor before starting to take aspirin because it might not be appropriate if you have a bleeding disorder or if you're already taking another blood thinner.
• Nitrates. These medications temporarily open arteries, improving blood flow to and from your heart. Better blood flow means your heart doesn't have to work as hard.
• Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure so blood can flow to your heart more easily.
• Calcium channel blockers. These medications relax and widen blood vessels, increasing blood flow in your heart. Calcium channel blockers also slow your pulse and reduce the workload on your heart.
• Cholesterol-lowering medications. These medications decrease the primary material that deposits on the coronary arteries.
• Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax blood vessels and lower blood pressure. Your doctor might recommend an ACE inhibitor if you have high blood pressure or diabetes in addition to myocardial ischemia.
• Ranolazine (Ranexa). This medication helps relax your coronary arteries to ease angina. Ranolazine may be prescribed with other angina medications, such as calcium channel blockers, beta blockers or nitrates.

Procedures to improve blood flow

Sometimes, more-aggressive treatment is needed to improve blood flow. Procedures that may help include:

• Angioplasty and stenting. A long, thin tube (catheter) is inserted into the narrowed part of your artery. A wire with a tiny balloon is threaded into the narrowed area and inflated to widen the artery. A small wire mesh coil (stent) is usually inserted to keep the artery open.
• Coronary artery bypass surgery. A surgeon uses a vessel from another part of your body to create a graft that allows blood to flow around the blocked or narrowed coronary artery. This type of open-heart surgery is usually used only for people who have several narrowed coronary arteries.
• Enhanced external counterpulsation. This noninvasive outpatient treatment might be recommended if other treatments haven't worked. Cuffs that have been wrapped around your legs are gently inflated with air then deflated. The resulting pressure on your blood vessels can improve blood flow to the heart.

Lifestyle and home remedies (Myocardial ischemia)

To follow a heart-healthy lifestyle:

• Quit smoking. Talk to your doctor about smoking cessation strategies. Also try to avoid secondhand smoke.
• Manage underlying health conditions. Treat diseases or conditions that can increase your risk of myocardial ischemia, such as diabetes, high blood pressure and high blood cholesterol.
• Eat a healthy diet. Limit saturated fat and eat lots of whole grains, fruits and vegetables. Know your cholesterol numbers and ask your doctor if you've reduced them to the recommended level.
• Exercise. Talk to your doctor about starting a safe exercise plan to improve blood flow to your heart.
• Maintain a healthy weight. If you're overweight, talk to your doctor about weight-loss options.
• Decrease stress. Practice healthy techniques for managing stress, such as muscle relaxation and deep breathing.

It's important to have regular medical checkups. Some of the main risk factors for myocardial ischemia — high cholesterol, high blood pressure and diabetes — have no symptoms in the early stages. Early detection and treatment can set the stage for a lifetime of better heart health.

Prevention---->