Myocardial Ischemia

What is Myocardial Ischemia?

Myocardial ischemia occurs when there is a deficiency in the blood supply that is going to the heart muscle, which in turn prevents it from getting enough oxygen to function properly. Reduced blood flow is typically caused by a blockage, whether partial or complete, of the coronary arteries of the heart. The condition can lead to significant damage to the heart muscles that hinders its ability to pump blood as it should.

Myocardial ischemia can progress slowly or set in quickly. If the blockage is sudden and severe, it can cause the patient to experience a heart attack. The disorder can also result in abnormal heart rhythms, some of which may be serious. Medical conditions that have been known to cause myocardial ischemia include blood clots, coronary artery disease, and coronary artery spasms. Additionally, some habits and medical issues increase a patient’s risk of developing the disorder, such as high blood pressure, tobacco use, diabetes, high cholesterol, obesity, and lack of physical activity.

What are the Symptoms of Myocardial Ischemia?

Some patients will not experience any signs of the condition, which is known as silent ischemia. When symptoms do appear, they often include:

  • Chest pressure or pain
  • Jaw or neck pain
  • Fast heartbeat
  • Arm or shoulder pain
  • Nausea
  • Vomiting
  • Shortness of breath with activity
  • Fatigue
  • Sweating 

When chest pain is present, it can be triggered by any number of situations such as emotional stress, illicit drug use, physical exertion, and cold temperatures.

Myocardial Ischemia Causes

Myocardial ischemia is most often caused by the build up of plaque””called atherosclerosis– in the arteries. Plaque is made up primarily of cholesterol and is associated with dietary and lifestyle factors. Poor diets, combined with a lack of exercise, create the conditions for plaque build up over time.

An associated cause is blood clots. In individuals with atherosclerosis, the plaque build up can rupture, causing clots. If the clot blocks an artery, the result is myocardial ischemia. In severe cases, the blockage may result in a heart attack. Clots may also originate in other parts of the body and travel to the coronary artery, although this is rare.

Less often, a spasm in the coronary artery can cause myocardial ischemia. Spasms are temporary contractions of the muscles in the wall of the artery. The constriction affects blood flow, decreases blood flow, or even completely blocks, resulting in pain, arrhythmia, or a heart attack.

How is Myocardial Ischemia Treated?

To treat myocardial ischemia, doctors recommend therapies aimed at improving blood flow to the muscles of the heart. Various medications can prove beneficial, such as nitrates, aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, calcium channel blockers, and drugs for lowering cholesterol.

Some cases may require more aggressive treatment in the form of surgical procedures. Depending on the severity, this could involve coronary artery bypass surgery, stenting, or angioplasty.

Myocardial Ischemia Prevention

The best way to prevent myocardial ischemia is to practice heart-healthy habits and reduce risk factors.

  • Stop smoking. Your healthcare provider can give you resources and tips to help.
  • Develop healthy eating habits. Choose foods that are low in saturated fat, along with whole grains and fruits and vegetables.
  • Monitor your cholesterol levels. Ask your health care provider about healthy cholesterol numbers and recommendations for how often you should have your levels tested.
  • Exercise regularly. Your healthcare provider can help you choose a safe and effective plan for your fitness level and goals.
  • Address underlying health issues, such as diabetes, high blood pressure, and high cholesterol. In addition to lifestyle changes, medication may be available to help you manage these conditions.
  • Stay at a healthy weight. Your healthcare provider can discuss weight management options with you to help you achieve and maintain your weight within recommended guidelines.
  • Reduce stress. Avoid stressful situations when possible, and learn to manage stress through techniques such as deep breathing, meditation, and self-care.

In addition to lifestyle changes, medications (such as beta blockers, blood thinners, or diuretics) may be prescribed for those with pre-existing conditions to help increase blood flow to the heart and reduce the risk of complications.