Cardiac ischemia is frequently caused by obstruction of a coronary artery with lipid fragments detached from endovascular atheroma plaques, but it can also be due to a functional vasospasm caused by exertion or exposure to extreme temperatures.
Why does coronary hypoperfusion occur?
What are the symptoms of cardiac ischemia
What is cardiac ischemia
Cardiac ischemia represents an imbalance between the oxygen and nutrient requirements of the heart and the coronary blood flow.
Why does coronary hypoperfusion occur?
Cardiac ischemia is frequently caused by obstruction of a coronary artery with lipid fragments detached from endovascular atheroma plaques, but it can also be due to a functional vasospasm caused by exertion or exposure to extreme temperatures.
The risk factors that determine the formation of atheroma plaques are represented by:
- Obesity
- Diabetes
- Smoking
- Chronic alcohol consumption
- Sedentarism
- Hypercholesterolemia, hypertriglyceridemia
- Genetic predisposition
- Metabolic dysfunctions
What are the symptoms of cardiac ischemia
The main symptoms of decreased coronary blood flow are represented by:
- Stable and unstable angina pectoris (due to physical exertion that increases the heart’s need for oxygen) manifests itself in the form of claw or retrosternal burning with radiation in the left arm, submandibular, interscapular or in the epigastrium
- Heart rhythm disorders
- Dyspnoea
- The feeling of dizziness
- Loss of consciousness
- Anxiety
- Integumentary pallor accompanied by excessive sweating
Diagnosis of cardiac ischemia
The diagnosis of ischemic heart disease is established based on the anamnesis and clinical examination of the patient, but also with the help of paraclinical investigations represented by:
- Medical laboratory analyses for the determination of creatine kinases CK and CKMB, cardiac troponin (troponin T), lactate dehydrogenase, liver enzymes
- Electrocardiogram, Holter EKG, cardiac ultrasound, computed tomography
- The stress test
- Coronarography: invasive method of diagnosis and treatment of cardiac ischemia performed under local anesthesia
Treatment in cardiac ischemia
The treatment of cardiac ischemia aims at the reperfusion (restoration of blood circulation) of the myocardial tissue and the fulfillment of the nutritional and oxygen needs of the heart, the therapeutic scheme for hospitalized patients includes:
- Percutaneous angioplasty with the installation of a stent to dilate and prevent re-obstruction of the affected artery
- Coronary bypass for the diversion of blood flow from the obstructed coronary artery through a graft obtained from a blood vessel (vein or artery) owned by the patient
- Administration of thrombolytic medication in the first 3 hours after the onset of ischemia and the anticoagulant
- Milder cases of cardiac ischemia are treated on an outpatient basis and benefit from therapy with antiplatelet agents, beta-blockers, vasodilators and converting enzyme inhibitors
If you have symptoms associated with cardiovascular diseases, contact your doctor for a specialist consultation!
References:
- Inhibition of miR-15 Protects Against Cardiac Ischemic Injury – https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.111.244442
- Thrombosis and Acute Coronary-Artery Lesions in Sudden Cardiac Ischemic Death – https://www.nejm.org/doi/full/10.1056/NEJM198405033101801
- Gender Differences in Cardiac Ischemic Injury and Protection—Experimental Aspects – https://journals.sagepub.com/doi/abs/10.3181/0812-MR-362
