What is cardiac ischemia? How serious is it?

Answers from Martha Grogan, M.D.

Cardiac ischemia occurs when blood flow to the heart muscle (myocardium) is decreased by a partial or complete blockage of a coronary artery. A sudden, severe blockage may lead to a heart attack (myocardial infarction). Cardiac ischemia may also cause a serious abnormal heart rhythm (arrhythmia), which can cause fainting or even sudden death.

Typical signs and symptoms of cardiac ischemia include:

  • Chest pain (angina pectoris)
  • Neck or jaw pain
  • Arm pain
  • Clammy skin
  • Shortness of breath
  • Nausea and vomiting

In some people, especially those with diabetes, cardiac ischemia may cause no signs or symptoms.

A doctor may make a diagnosis of cardiac ischemia based on:

  • Medical history
  • Physical examination
  • Electrocardiogram
  • Stress test
  • X-rays of coronary arteries (coronary angiogram)

Treatment is directed at improving blood flow to the heart muscle and may include:

  • Medication such as aspirin, beta blockers and nitrates. During a heart attack, thrombolytic agents, or "clot-busters," may be used.
  • Angioplasty or stent placement (percutaneous coronary intervention, or PCI).
  • Coronary artery bypass surgery.

Exercise may improve blood flow to the heart muscle after the condition is stabilized.

May. 22, 2008 See more Expert Answers