What Is Ischemia? Treatment for Acute or Chronic Ischemia

What is ischemia?

Ischemia is the medical term used to describe a lack of blood flow to certain organs or body parts. Since the blood carries oxygen and other necessary nutrients to parts of the body, when blow flow is reduced these body parts do not receive the adequate amount of oxygen and nutrients they need to function properly. Ischemia is reversible if there is an improvement in the blood flow and the affected tissue will recover. It can be irreversible when there is no improvement in the blood flow, which can cause the death of the affected tissue. Ischemia can be acute or chronic. In the former there is a sudden reduction, and in the later there is a gradual reduction in blood flow.

Ischemia can be developed in any part of the body, affecting any tissue. Ischemia can cause heart attacks and stroke, especially in cardiac ischemia or lack of blood flow to the heart. In very rare cases, ischemia can affect the intestines causing pain in the abdomen, blood in stools and also intestinal damage or gangrene. In peripheral ischemia, there is a risk of loss of fingers or toes or limb amputation.

The most common sign of ischemia is pain in the affected area, but it does not always occur. In brain ischemia, the patient can suffer from cognitive, sensory and motor problems. In heart and intestinal ischemia, the patient might have nausea and/or vomiting. And in peripheral ischemia, the patient can have pallor and darkening of the skin.

Some of the risk factors that increase the chances of ischemia are arteriosclerosis, high blood pressure, high cholesterol, heart issues, diabetes, use of tobacco, lack of physical exercise, stress, family history of ischemia, illness and old age. The treatment of ischemia will depend on its cause, but majorly the objective will be to restore the blood flow in the affected area and prevent further damage to the tissue.

Acute ischemia is a serious condition and needs immediate medical treatment. One must seek immediate medical assistance if he or she is experiencing pain or pressure in the chest, breathing problems, severe headache, pain in the abdomen, confusion, loss of consciousness, sudden problems with memory, thinking, talking or writing, numbness, paralysis, loss or change in vision, vomiting blood, bloody stool, rectal bleeding, sweating profusely, anxiety and darkening or patches on skin.

One must also seek medical assistance if being treated for ischemia and the symptoms reoccur or continue without any improvement, start experiencing breathing problems, reduction in physical activity, slow loss of memory, start developing change in skin color, sores not getting healed on legs or feet, leg pain while walking or climbing, pain in abdomen while eating or any other symptoms.

Chronic ischemia:

The coronary arteries that supply blood to the heart are narrowed to the extent that it limits the flow of blood to the heart all the time, even while resting. When this happens, ischemia becomes a chronic condition which will gradually weaken the heart.

Silent ischemia:

Some people have ischemia but will not experience chest pain or any other symptoms, and this condition is known as silent ischemia. This condition is seen more in women, older adults and people suffering from diabetes. Silent ischemia is of concern particularly after a heart attack since it increases the chances of another heart attack.

Symptoms of ischemia

The symptoms depend upon the location of the disease.

Common symptoms of cardiac ischemia include:

• Pain or pressure in the chest which can extend to the arm, shoulder, jaw, neck, back or abdomen
• Reduction in physical abilities
• Nausea and/or vomiting
• Irregular heartbeats
• Sweating profusely
• Breathing problems

Common symptoms of ischemia of brain include:

• Unusual pupil size or no reaction of the pupil to light
• Issues with balancing, tendency to fall and difficulty in walking
• Confusion
• Problems with memory, thinking, talking, understanding, writing or reading
• Fainting
• Headache
• Lack of muscle coordination
• Loss or change in vision
• Blurred vision
• Nausea and/or vomiting
• Tiredness
• Numbness
• Paralysis
• Drooping eyelids

Common symptoms of ischemia in other parts of the body include:

• Pain or discomfort in abdomen while eating
• Bloody and colored stools
• Diarrhea
• Pain in leg while walking or climbing
• Nausea and/or vomiting
• Sores that don’t get healed
• Darkening of skin color

Serious symptoms that indicate a life-threatening condition are:

• Unusual pupil size or no reaction of the pupil to light
• Pain, pressure or tightness in chest
• Change in the levels of consciousness, for example passing out
• Inability to speak or unclear speech
• Hallucinations
• Paralysis
• Breathing problems
• Seizure
• Unbearable pain in the abdomen
• Severe headaches
• Blurred vision or loss of vision
• Vomiting blood
• Passing blood in stools
• Drooping eyelids

Causes of ischemia

A reduction in the blood supply to a tissue or organ causes ischemia. Blood flow can be reduced or prevented by a clot, an embolus or restriction of an artery. It can occur when the artery wall gets thickened, and it narrows the artery as in the case of atherosclerosis. The other cause can be trauma which can interrupt the blood flow.

Risk factors of ischemia

There are various factors that can increase the chance of developing ischemia which include:

• Irregular heartbeat
• Diabetes
• High blood pressure
• High cholesterol
• Gender - Men are more prone to getting ischemia than women
• Age – Older adults are more at risk than younger individuals
• Obesity
• Physical inactivity
• Stress
• Trauma
• Smoking or using any other form of tobacco
• Vascular diseases

Some of the factors that can reduce the risk of developing ischemia are:

• Controlling the blood sugar levels
• Eating healthy food
• Working out regularly and doing other physical activities like walking, climbing stairs, etc.
• Keeping continuous check on weight and taking necessary steps if there is excessive weight gain
• Stopping smoking or use of any other tobacco products
• Controlling stress levels
• Taking medicines regularly as prescribed by the doctor for any heart disease, cholesterol, diabetes or high blood pressure

Treatment of ischemia

Regular medical care throughout a person's life is the first step in treating and preventing ischemia. With regular medical care, the doctor will be in a position to continuously check the health of the person, do some tests if required, and assess any symptoms to avoid the risk of developing ischemia.

The objective of treating ischemia is to improve the blood flow in the affected area and avoid any further damage. In some cases, there may be a need for surgery to remove dead tissue or repair the affected area. Once the blood flow is restored through proper medication or surgery, the next step is to avoid development of ischemia in the future.

Treatment options for acute or chronic ischemia

These treatment options mentioned below help to reduce ischemia and restore blood flow:

• Painkillers
• Medicines to widen the blood vessels
• Medicines to stop the ongoing clot formation
• Medicines to reduce the pressure or workload of the heart
• Oxygen therapy
• Specific procedures to widen blood vessels
• Surgery to remove the clots or bypass the blood vessels
• Thrombolytic drugs for the clots to get dissolved

Complications of ischemia

If ischemia is left untreated, it can lead to numerous serious complications and at times even death. A person can avoid complications by working out an appropriate treatment plan with the doctor.

Some of the complications of ischemia are:

• Reduced or altered sensation
• Amputation
• Loss of eyesight
• Reduced cognitive function
• Heart failure
• Paralysis
• Permanent disability