Cardiac ischemia

Cardiac ischemia occurs when blood flow to the heart muscle (myocardium) is obstructed 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.