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MyochardialIschemiaMyocardial Ischemia: Causes, Symptoms, Prevention, Medications and Treatments

Commonly asked questions about myocardial ischemia

What is Myocardial Ischemia?

Myocardial ischemia occurs when the blood flow to your heart is reduced. When blood flow is reduced it makes it so that your heart is unable to get the oxygen that it needs to function properly. Usually the reduced blood flow is caused by a complete or partial blockage of the heart’s arteries. Myocardial ischemia can also cause damage your heart’s muscle, this damage may reduce its ability to pump blood efficiently. The blockage formed in the arteries can cause a heart attack or severely abnormal heart rhythms.

What can Cause Myocardial Ischemia?

Myocardial ischemia occurs when blood flowing through one or more arteries decreases.This can develop slowly over time as arteries become blocked by a build up of plaque or it can occur quickly if an artery becomes blocked suddenly. When the blood flow is lessened it decreases the amount of oxygen that your heart receives which can cause damage to the heart and muscles. According to the Mayo Clinic there are also several pre-existing conditions that can lead to myocardial ischemia.

  • Coronary Artery Disease: Plaque made up of mostly cholesterol builds up on the walls of your arteries restricting blood flow to the heart.
  • Blood Clot: The plaque that develops in an atherosclerosis can rupture and cause a blood clot. The clot may block an artery and lead to sudden, severe myocardial ischemia that could cause a heart attack.
  • Coronary Artery Spasm: A temporary tightening of the muscles in the artery. This event can briefly decrease or prevent the blood flow to part of the heart muscle. A coronary artery spasm is an uncommon cause of myocardial ischemia.

What are the Symptoms/Signs of Myocardial Ischemia?

Health Line states that there are several symptoms that you may experience when suffering from myocardial ischemia that may include one or more of the following. However there is also a form of ischemia known as “silent ischemia” that will not show any of the following symptoms. The Texas Heart Institute estimates that 3 to 4 million Americans suffer from silent ischemia every year.

  • Extreme fatigue
  • Shortness of breath
  • Dizziness, lightheadedness or fainting
  • Chest pain or pressure
  • Heart palpitations
  • Swelling of the legs or feet
  • Swelling in abdomen
  • Cough or congestion caused by fluid in lungs
  • Difficulty sleeping
  • Weight gain

What Risk Factors are Associated with Myocardial Ischemia?

There are several risk factors that are associated with myocardial ischemia. The following is a list from the Mayo Clinic of factors that are known to increase your chances of developing a myocardial ischemia.

Risk FactorsDescription
TobaccoSmoking or extended exposure to secondhand smoke can damage the inside walls of arteries. This damage allows deposits of cholesterol along with other substances to collect and slow blood flow in the coronary arteries. Smoking can also increase the risk of blood clots.
DiabetesBoth types 1 and 2 diabetes have been linked to an increased risk of myocardial ischemia, heart attack and other heart problems.
High Blood PressureHaving high blood pressure for an extended period of time can accelerate atherosclerosis, which can result in damage to the coronary arteries.
High Cholesterol LevelCholesterol plays a huge role in the deposits that have the ability to narrow your coronary arteries. A high level of “bad”cholesterol in your blood may be from an inherited condition or a diet high in saturated fats and cholesterol.
High Blood Triglyceride LevelTriglycerides are another blood fat that may contribute to atherosclerosis.
ObesityObesity is linked to diabetes, high blood pressure and high blood cholesterol levels. All are things that can lead to heart disease.
Lack of Physical ActivityBeing inactive contributes to obesity and is associated with higher cholesterol and triglyceride levels. People who get regular exercise have better cardiovascular fitness, which helps decrease the risk of myocardial ischemia and heart attack. Exercise also helps to lower high blood pressure.

How can I Help Prevent Myocardial Ischemia?

Many of the risk factors associated with myocardial ischemia can be avoided or alleviated by leading a healthier lifestyle. This includes exercising on a regular basis, eating a heart-healthy diet, stopping tobacco consumption and reducing alcohol intake.

What Drugs/Medicines are used to Treat Myocardial Ischemia?

The following is a list of medications/drugs from the Mayo Clinic that are used to help treat various heart conditions including myocardial ischemia.

  • Aspirin/Blood Thinner: A daily aspirin or blood thinner helps to reduce your risk of blood clots.
  • Nitrates: Nitrates temporarily open arteries, allowing for improved blood flow to and from your heart. This means your heart will not have to work as hard.
  • Beta blockers: Help relax your heart muscle, slow your heart rate and decrease blood pressure, allowing blood to flow to your heart easier.
  • Calcium channel blockers: These help to relax and widen blood vessels, allowing for increased blood flow to your heart. Calcium channel blockers also help to slow your pulse and reduce the amount of work your heart has to do.
  • Cholesterol-lowering medications: These are used to decrease the main material that deposits on the coronary arteries.
  • Angiotensin-converting enzyme (ACE) inhibitors: These help relax blood vessels and lower blood pressure.
  • Ranolazine (Ranexa): This helps to relax your coronary arteries to ease chest pain.

View Sources

  1. Mayo Clinic – Causes
  2. Health Line – What is Myocardial Ischemia 
  3. Texas Heart Institute – Silent Ischemia
  4. Mayo Clinic – Risk Factors
  5. Mayo Clinic – Treatments and Drugs

 

Resources

Andrews T, Raby K, Barry J, Naimi C, Allred E, Ganz P, Selwyn A, Effect of cholesterol reduction on myocardial ischemia in patients with coronary disease, 1997,AHA Journals, ,

Hedman M, Hartikainen J, Syvänne M, Stjernvall J, Hedman A, Kivelä A, Vanninen E, Mussalo H, Kauppila HSimula K, Närvänen O, Rantala A, Peuhkurinen KNieminen M, Laakso M, Ylä-Herttuala S, Safety and Feasibility of Catheter-Based Local Intracoronary Vascular Endothelial Growth Factor Gene Transfer in the Prevention of Postangioplasty and In-Sent Restenosis and in the Treatment of Chronic Myocardial Ischemia, 2003, AHAJournals, ,