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Written by Administrator
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Cause
Cardiac ischemia occurs when blood flow to the heart muscle
(myocardium) is obstructed by a partial or complete blockage of a
coronary artery.
The lack of oxygen is often temporary, and symptoms can include a type of chest pain, pressure or discomfort called angina pectoris.
These episodes may last anywhere from 2 to 20 minutes. However, many
episodes of ischemia do not have any associated symptoms (silent ischemia).
Minor episodes of cardiac ischemia tend to cause little long-term
damage to the heart, but there may be serious side effects in some
patients:
- They can cause abnormal heart rhythms (arrhythmias), which can lead to either syncopecardiac arrest (the abrupt inability of the heart to pump blood) and sudden cardiac death.
- Severe or lengthy episodes can trigger a heart attack.
- The collective effects of minor episodes of cardiac ischemia can potentially lead to a weakening of the heart muscle (cardiomyopathy).
A sudden, severe blockage may lead to a heart attack
(myocardial infarction). Lengthy episodes of cardiac ischemia can also be a sign of a heart attack.
A heart attack occurs when a blood clot blocks the flow of blood to the
heart muscle. It can occur in an artery already narrowed by plaque (atherosclerosis ),
or a heart attack can occur after a blood clot breaks off from its
original site and travels through the arteries. The blockage causes a
sudden and possibly complete interruption of oxygen-rich blood flow,
and the resulting heart attack could cause permanent damage and
scarring to the portion of the heart muscle supplied by the blocked
artery.
Typical signs and symptoms of cardiac ischemia include:
- Chest pain (angina pectoris)
- Neck, jaw pain or arm pain
- Shortness of breath
- Nausea and vomiting
- Clammy skin
In some people, especially those with diabetes, cardiac ischemia may cause no signs or symptoms.
Diagnosis
A doctor may make a diagnosis of cardiac ischemia based on:
- Medical history
- Physical examination
- Electrocardiogram (ECG)
- Stress test
- X-rays of coronary arteries (coronary angiogram)
Treatment
Treatment is directed at improving blood flow to the heart muscle and may include:
- Medication such as aspirin, beta blockers and
nitrates. During a heart attack, thrombolytic agents, or "clot
busters," may be used.
- Angioplasty or stent placement (percutaneous coronary intervention, or PCI).
- Coronary artery bypass surgery.
- Exercise may improve blood flow to the heart muscle after the condition is stabilized.
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