Table of contents:
- Types of cardiac ischemia
- How the treatment is done
- Symptoms of cardiac ischemia
- Causes of cardiac ischemia
- How the diagnosis is made
Cardiac ischemia, also known as myocardial ischemia or myocardial ischemia, is characterized by a decrease in the flow of blood through the coronary arteries, which are the vessels that carry blood to the heart. It is usually caused by the presence of fatty plaques inside, which, when not properly treated, can rupture and clog the vessel, causing pain and increasing the chances of a heart attack.
Its treatment is done with medications to improve the blood flow of these vessels, prescribed by the cardiologist, such as metoprolol, simvastatin and AAS, for example, in addition to controlling cholesterol and s alt in food and physical activity.
Types of cardiac ischemia
Obstruction of blood flow through the coronary arteries can happen in different ways:
- Stable angina: it is a type of chronic but transient ischemia, because chest pain appears when the person makes some effort, suffers some emotional stress or after eating, and improves and a few minutes or when you rest. If not treated, it can become a heart attack in the future.
- Unstable angina: this is also a type of chronic ischemia, but chest pain can occur at any time, lasts longer than 20 minutes, does not improve with rest, and, if not treated quickly, will progress to a heart attack. Understand better what angina is, its causes and how to treat it.
- Acute myocardial infarction: the infarction can happen after angina has transformed, or it can be sudden, appearing without warning. It is characterized by intense pain or burning in the chest that does not improve, and should be treated as soon as possible in the emergency room.Learn how to identify a heart attack.
- Silent ischemia: it is the decrease in the flow of blood in the coronary arteries that does not cause symptoms, being often discovered in routine exams, and causes a great risk of progressing to a heart attack or sudden cardiac arrest.
These types of ischemia cause great impairment of heart he alth, therefore, they must be diagnosed and treated as soon as possible, either by performing annual check-ups, or by always seeking care with a general practitioner or cardiologist symptoms of pain or burning in the chest appear.
How the treatment is done
The treatment for cardiac ischemia can be done with the use of medication for:
- Reduce heart rate, such as propranolol, atenolol, or metoprolol;
- Control blood pressure levels, such as enalapril, captopril, or losartan;
- Reduce fatty plaques such as simvastatin and atorvastatin;
- Decrease the formation of blood clots, such as AAS or clopidogrel, to break up fatty plaques;
- Dilate heart vessels, such as isordil and monocordil.
These medications should only be used under strict guidance from the cardiologist. Diseases such as high cholesterol, high blood pressure, smoking, sedentary lifestyle, diabetes, sleep apnea and anxiety attacks should also be controlled, as they can increase the risk of cardiac ischemia.
In more severe cases, when the use of medication is not enough, the cardiologist may recommend surgery, which is a delicate procedure in which the patient can stay in the hospital for more than 4 days and must undergo physiotherapy still in hospital for early cardiac rehabilitation. The doctor may request, for example, angioplasty with or without the placement of a stent or myocardial revascularization surgery, which is the replacement of a coronary artery by the saphenous vein, for example.Understand how coronary bypass surgery is performed.
Symptoms of cardiac ischemia
Symptoms of cardiac ischemia can be:
- Chest pain or burning that may radiate to the back of the neck, chin, shoulders, or arms;
- Heart palpitations;
- Chest pressure;
- Shortness of breath or difficulty breathing;
- Sickness, cold sweat, pallor and malaise;
However, cardiac ischemia may have no symptoms and is only discovered in a routine examination or when it causes a heart attack. Here are the 12 signs that can indicate heart problems.
Causes of cardiac ischemia
The main cause of cardiac ischemia is atherosclerosis, which is the accumulation of fat within the coronary arteries, due to the long-term effect of high cholesterol, high sugar, physical inactivity, smoking and obesity.
However, other diseases can lead to cardiac ischemia, such as lupus, diabetes, coronary embolism, syphilis, aortic stenosis, coronary spasm, very severe hyperthyroidism and use of drugs such as cocaine and amphetamines.
How the diagnosis is made
To identify the presence of ischemia in the heart, some tests can be performed, which must be requested by the general practitioner or cardiologist, such as:
- Ergometric test or stress test;
- Myocardial scintigraphy.
Blood tests are performed to identify the presence of alterations that cause risk to the heart, such as cholesterol, blood glucose, triglycerides and kidney function, for example. When a heart attack is suspected, a blood test to assess the levels of cardiac enzymes can also help confirmation.Find out which tests are requested to evaluate the heart.
Each exam requested depends on the symptoms presented by the person, and, if there is still doubt, the cardiologist can request a cardiac catheterization to confirm the presence of cardiac ischemia. Find out what it's for, how it's done and the risks of cardiac catheterization.