Ischemia is the medical term for what happens when your heart muscle
doesn't get enough oxygen. Ischemia usually happens because of a shortage of
blood and oxygen to the heart muscle. It is usually caused by a narrowing or
blockage of one or more of the coronary arteries (which supply blood to the
heart muscle). In many cases ischemia is a temporary problem. Your heart may be
able to get enough blood through your diseased coronary arteries while you are
resting but may suffer from ischemia during exertion or stress.
Your coronary arteries may become so narrowed that they limit the
flow of blood to your heart all the time, even when you are at rest. If this
happens, ischemia can become an ongoing (chronic) condition that can
progressively weaken your heart.
When your heart suffers from ischemia, you will typically experience
pain or discomfort in your chest. Angina is the medical term for this chest
sensation, which is the most common symptom of coronary artery disease (CAD).
It's important to know that people with CAD who experience angina
often describe the sensation as "tightness," "discomfort," "squeezing," and
"heaviness." The pain or discomfort of angina tends to start under your
breastbone but may also travel, often to your shoulder, arm, neck, or jaw.
Often people also have shortness of breath, sweating, and a feeling of nausea
along with the anginal chest pain or discomfort. Sometimes ischemia causes
these other symptoms without causing chest pain or discomfort.
For reasons that doctors don't fully understand, some people have
ischemia but do not feel chest pain or discomfort or any other symptoms.
This condition is called silent ischemia.
Silent ischemia occurs most often in women, older people, and people who have diabetes.
People with silent ischemia typically find out that they have it when
their doctor notices that their routine electrocardiogram (EKG), ambulatory
EKG, or stress test results indicate that their hearts aren't getting enough
blood. Silent ischemia is a particular concern after a heart attack, because it
increases the chance of another heart attack.
April 6, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& Robert A. Kloner, MD, PhD - Cardiology
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