Myocardial ischemia occurs when the blood flow through one or more of the blood vessels that lead to your heart (coronary arteries) is decreased. This decrease in blood flow leads to a decrease in the amount of oxygen your heart muscle (myocardium) receives. Myocardial ischemia may occur slowly as arteries become blocked over time, or it may occur quickly when an artery becomes blocked suddenly.
Conditions that may cause myocardial ischemia include:
- Coronary artery disease (atherosclerosis). Atherosclerosis occurs when plaques made of cholesterol and waste products build up on your artery walls and restrict blood flow. Atherosclerosis of the heart arteries is called coronary artery disease and is the most common cause of myocardial ischemia.
- Blood clot. The plaques that develop in atherosclerosis can rupture, causing a blood clot, which may lead to sudden, severe myocardial ischemia, resulting in a heart attack.
- Coronary artery spasm. A coronary artery spasm is a brief, temporary tightening (contraction) of the muscles in the artery wall. This can narrow and briefly decrease or even prevent blood flow to part of the heart muscle.
Things that may trigger chest pain associated with myocardial ischemia include:
Mar. 06, 2014
- Physical exertion
- Emotional stress
- Cold temperatures
- Lying down
- Cocaine use
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Oct. 15, 2013.
- American Heart Association. http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Silent-Ischemia-and-Ischemic-Heart-Disease_UCM_434092_Article.jsp. Accessed Oct. 17, 2013.
- Fihn SD, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. Journal of the American College of Cardiology. 2012;30:e44.
- Podrid PJ. Pathophysiology and clinical presentation of ischemic chest pain. http://www.uptodate.com/home. Accessed Oct. 15, 2013.
- Fuster V, ed. et al. Hurst's The Heart. 13th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=5. Accessed Oct. 15, 2013.
- What are coronary heart disease risk factors? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hd/printall-index.html. Accessed Oct. 17, 2013.