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Coronary ischemia, myocardial ischemia, [1] or cardiac ischemia, [2] is a medical term for abnormally reduced blood flow in the coronary circulation through the coronary arteries. [3] Coronary ischemia is linked to heart disease, and heart attacks. [4] Coronary arteries deliver oxygen-rich blood to the heart muscle. [5]
The diagnosis of myocardial infarction requires two out of three components (history, ECG, and enzymes). When damage to the heart occurs, levels of cardiac markers rise over time, which is why blood tests for them are taken over a 24-hour period. Because these enzyme levels are not elevated immediately following a heart attack, patients ...
Ischemia results in tissue damage in a process known as ischemic cascade. The damage is the result of the build-up of metabolic waste products, inability to maintain cell membranes , mitochondrial damage, and eventual leakage of autolyzing proteolytic enzymes into the cell and surrounding tissues.
Similar to hypertensive retinopathy, evidence of nerve fiber infarcts due to ischemia (cotton-wool spots) can be seen on physical exam. Symptoms may include headache, nausea, or vomiting. Chest pain may occur due to increased workload on the heart resulting in inadequate delivery of oxygen to meet the heart muscle's metabolic needs.
The diagnosis of microvascular angina (previously known as cardiac syndrome X – the rare coronary artery disease that is more common in females, as mentioned, is a diagnosis of exclusion. Therefore, usually, the same tests are used as in any person suspected of having coronary artery disease: [ 77 ]
Post-cardiac arrest syndrome (PCAS) is an inflammatory state of pathophysiology that can occur after a patient is resuscitated from a cardiac arrest. [1] While in a state of cardiac arrest, the body experiences a unique state of global ischemia.
Symptoms of the acute coronary syndromes are similar. [8] The cardinal symptom of critically decreased blood flow to the heart is chest pain, experienced as tightness, pressure, or burning. [9] Localization is most commonly around or over the chest and may radiate or be located to the arm, shoulder, neck, back, upper abdomen, or jaw. [9]
Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. [4] Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, [5] however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction.