Cardiac ischemia: what it is, main symptoms and treatment

Cardiac ischemia or myocardial ischemia is characterized by decreased blood flow 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 drugs to improve the blood flow of these vessels, prescribed by the cardiologist, such as metoprolol, simvastatin and AAS, for example, in addition to the control of cholesterol and salt in the diet and physical activity.

Types of cardiac ischemia

Coronary blood flow obstruction can happen in different ways:

• Stable angina: it is a type of chronic ischemia, but transient, because the chest pain arises when the person makes some effort, suffers some emotional stress or after eating, and improves in a few minutes or when he rests. If left untreated, it can become a heart attack in the future. Unstable angina: it is also a type of chronic ischemia, but chest pain can appear at any time, lasts more than 20 minutes, does not improve with rest, and, if not treated quickly, will develop into a heart attack. Better understand what angina is, its causes and how to treat it. Acute myocardial infarction: the infarction can happen after transformation of angina, or it can be sudden, appearing without warning. It is characterized by severe pain or burning in the chest, which 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 blood flow 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 major impairment of heart health, so they should be diagnosed and treated as soon as possible, both by performing annual check-ups, as well as seeking care with a general practitioner or cardiologist whenever symptoms of pain appear. or burning in the chest.

How the treatment is done

Treatment for cardiac ischemia can be done using medications 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 ASA or clopidogrel, for the breakdown of fatty plaques; Dilate the vessels of the heart, such as isordil and monocordile.

These drugs should only be used under strict guidance from the cardiologist. Diseases such as high cholesterol, high blood pressure, smoking, physical inactivity, diabetes, sleep apnea and anxiety attacks should also be controlled, as they can increase the risk of cardiac ischemia.

In the most severe cases, when the use of medications 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 physical therapy while still in the hospital for rehabilitation. early heart rate. The doctor may order, for example, angioplasty with or without the placement of a stent or coronary artery bypass graft, which is the replacement of a coronary by the saphenous vein, for example. Understand how bypass surgery is done.

Symptoms of cardiac ischemia

Symptoms of cardiac ischemia can be:

• Pain or burning in the chest that can radiate to the neck, chin, shoulders or arms; Heart palpitations; Pressure in the chest; Shortness of breath or difficulty breathing; Sickness, cold sweat, pallor and malaise;

However, cardiac ischemia may not show symptoms and is only discovered on a routine examination or when it generates a heart attack. See what 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 done, which should be requested by the general practitioner or cardiologist, such as:

• Electrocardiogram; Exercise test or stress test; Echocardiogram; Myocardial scintigraphy.

Blood tests are performed to identify the presence of changes that cause risk to the heart, such as cholesterol, blood glucose, triglycerides and kidney function, for example. When a heart attack is suspected, blood tests to assess cardiac enzyme levels can also help confirmation. Find out which tests are requested to assess the heart.

Each test ordered depends on the symptoms presented by the person, and if there is still doubt, the cardiologist may request a cardiac catheterization to confirm the presence of cardiac ischemia. Know what it is for, how it is done and the risks of cardiac catheterization.